Purpose:The main objective of the study was to evaluate the effect of air gaps of 0 -5.0 cm between bolus and skin for 1.0 cm Superflab bolus on surface dose (D Surf ) and depth of maximum dose (d max ) in solid water and Rando ® phantoms. Methods: In this work, the effects of bolus to surface distance on D Surf and variation in d max were analyzed in a solid water phantom and in an anthropomorphic Rando ® phantom for different field sizes, using Gafchromic ® EBT films and farmer chamber. D Surf is largely unaffected by air gaps. However, smaller air gap results in shallower d max for both 6 MV and 10 MV photon beams at all fields sizes. Special consideration should be taken to reduce air gaps between bolus and skin for field sizes smaller than 10 × 10 cm 2 or when surface contour variations are greater or when the bolus covers small area and at the border of the field.

This study intends to examine corporate social responsibility (CSR) in Pakistan’s banking sector, CSR disclosure practices and their impact on financial performance. For the study, relevant data was collected from the banks’ annual reports, financial websites, the State Bank of Pakistan (SBP) and the Pakistan Stock Exchange (PSE) from 2008 to 2018. The methods utilized in this research study were content analysis and panel data techniques. The results indicate an increase in overall CSR disclosure by all banks in the sample and the findings suggest the involvement of commercial banks in CSR activities, and its proper disclosure has helped to improve their accounting-based financial performance proxied by the return on equity (ROE) and return on assets (ROA). The research findings contribute to a better understanding of the CSR practices in the financial sector of an emerging country, which makes a dynamic effort to develop its financial culture and can encourage rapprochement with Pakistan’s financial sector.

Rotator cuff disorders are considered to be among the most common causes of shoulder pain and disability encountered in both primary and secondary care.The general pathology of subacromial impingment generally relates to a chronic repetitive process in which the conjoint tendon of the rotator cuff undergoes repetitive compression and micro trauma as it passes under the coracoacromial arch. However acute traumatic injuries may also lead to this condition.Diagnosis remains a clinical one, however advances in imaging modalities have enabled clinicians to have an increased understanding of the pathological process. Ultrasound scanning appears to be a justifiable and cost effective assessment tool following plain radiographs in the assessment of shoulder impingment, with MRI scans being reserved for more complex cases.A period of observed conservative management including the use of NSAIDs, physiotherapy with or without the use of subacromial steroid injections is a well-established and accepted practice. However, in young patients or following any traumatic injury to the rotator cuff, surgery should be considered early. If surgery is to be performed this should be done arthroscopically and in the case of complete rotator cuff rupture the tendon should be repaired where possible.

Frozen shoulder is a common, disabling but self-limiting condition, which typically presents in three stages and ends in resolution. Frozen shoulder is classified as primary (idiopathic) or secondary cases. The aetiology for primary frozen shoulder remains unknown. It is frequently associated with other systemic conditions, most commonly diabetes mellitus, or following periods of immobilisation e.g. stroke disease. Frozen shoulder is usually diagnosed clinically requiring little investigation. Management is controversial and depends on the phase of the condition. Non-operative treatment options for frozen shoulder include analgesia, physiotherapy, oral or intra-articular corticosteroids, and intra-articular distension injections. Operative options include manipulation under anaesthesia and arthroscopic release and are generally reserved for refractory cases.

Introduction. Debate exists amongst surgeons regarding the ideal suture material for skin closure in carpal tunnel decompression (CTD). This study compares wound related complications, patient satisfaction, and functional outcome following open carpal tunnel decompression in patients undergoing wound closure with either of two common absorbable and nonabsorbable suture types. Materials and Methods. 53 patients underwent CTD with either 4/0 polypropylene (ProleneTM, n = 28) or 4/0 polyglactin (Vicryl RapideTM, n = 25) for skin closure. QuickDASH, VAS satisfaction scores, and Southampton wound scores were assessed preoperatively and at 2 and 6 weeks postoperatively. Results. At 6 weeks the mean QuickDASH scores postoperatively were 18.54 and 17.70 for absorbable and nonabsorbable sutures, respectively, (P = 0.86). The mean VAS scores were 0.61 and 0.42 (P = 0.91), respectively. All patients achieved a Southampton wound score of 0 by 6 weeks except one, who achieved 1C in the nonabsorbable group, equivalent to mild erythema. There were no complications in either group. Conclusion. Both suture types are safe and effective materials for CTD, and we recommend surgeons to choose according to personal preference, handling properties, and resources available for suture removal.