Ratio analysis Essay Example | Topics and Well Written Essays - 2500 words

Ratio analysis - Essay Example The former is used to compare the performance of the firm within itself in terms of aspects such as improvement in management skills and finance handling. The latter is used to compare the performance of the firm within its industry of operation. Such comparisons will consider fundamental aspects of operations like profitability. In profitability, an increase or decrease is established and the causes of each including what can be done to stabilize profitability and grow it further. The liquidity of the firm is also quite fundamental as this would enable management know how to plan operations and sources of financing. Therefore, ratio analysis is used in the determination of trends as it strives to expose the strengths and weaknesses of the company. Ratios can be either favorable or unfavorable depending on whether the increase or decrease is in the desired direction (Dess 2012). For our analysis of Apple Incorporation’s financial statement of the year 2012 compared to that of the year 2011, we will categorize ratios into the following - Profitability Ratios; Liquidity ratios; Efficiency Ratios and Capital structure ratios. Profitability Ratios They measure the ability of the company to generate profits from their asset investments. Such ratios include- Gross Profit margin, which is the profit before expenses generated by sales as a percentage. There is the Net Profit margin which are the earnings before depreciation and tax generated by sales; Then there is the Return on Equity(ROE)/Net Worth/ Shareholders funds/ Investments(ROI), this is the ratio of the earnings after tax plus preference dividends contributed by share capital and reserves. The fourth ration in this category is the Return on total assets (ROTA) which indicates how much the Fixed and Current Assets of a company contributes to the Earnings before Interest and Tax (EBIT). Return on Capital Employed is the next, it indicates how equity and Fixed interest capital contributes to the EBIT, and finally we have the Operating Expenses Ratio indicating the percentage of sales consumed by the operating expenses. An increase in these ratios from the previous period is considered favorable while a decrease in the last ratio is considered favorable. The ratios as shown by the financial data by Apple incorporation between the years 2011 and 2012 financial statements are as shown in the table below. RATIO FORMULA YEAR 2012($ in Millions) YEAR 2011($ in Millions) 1. Gross Profit Margin = (Gross Profit/Sales)*100 (66,662/156,508)*100 = 43.87% (43,818/108,249)*100 = 40.48% 2. Net Profit Margin =(EBIT/Sales)*100 (55,241/156,508)*100 = 35.30% (34,790/108,249)*100 = 32.14% 3. ROE/ROI =(EAT+ Pref. dividends/Owner’s Equity)*100 (41,733/118,210)*100 = 35.30% (25,922/76,615)*100 = 33.83% 4. ROTA =(EBIT/Total Assets)*100 (55,241/176,064)*100 = 31.38% (34,790/116,371)*100 = 29.90% 5. ROCE =(EBIT/Total Capital Employed)*100 (55,241/118,210)*100 = 46.73% (34,790/76,615)*100 = 45.41% 6. O perating Expenses Ratio =(Operating Expenses/Sales)*100 (13,421/156,508)*100 = 80.58% (10,028/108,249)*100 = 9.26% As indicated by the profitability ratios, there was a general increase in profitability of Apple Inc between the year 2011 and 2012. The gross profit margin shows a rise from 40.48% in 2011 to 43.87% in 2012. Such an increase was because of the increase in; sales from 108,249 in 2011 to 156,508 in 2012. An increase of the net profit margin from 32.14% to 35.3% is because of the i

Organization Design Essay Example | Topics and Well Written Essays - 250 words

Organization Design - Essay Example For example, in the case of a pharmaceutical company, power is retained by the R&D department because it is the very department that generates resources. Which subunits qualify for receiving the information is dictated by the organizational structure. When a certain subunit in the organizational structure has more control over information compared to other subunits, it is capable of influencing the opinions and accordingly influence the decision making process. Subunits that are central to the organization have more power than others. Manufacturing is central in a low-cost organizational culture. Organizations sometimes need to assign more power to a certain subunit in order to ensure that it makes optimal use of the resources. The balance of power between the different subunits is not always suitable for effective utilization of the resources (Jones, 2010, p. 423). Apart from this, there can be relational ties between the executive managers and the head of one of the subunits, which can become a reason for more delegation of power to that subunit compared to

Study of Peak Oil and Gas Essay Example for Free

Study of Peak Oil and Gas Essay In 2004, the world production of oil was estimated at just over 29. 7 Bbl. The corresponding world consumption for oil during the same period was estimated at 29. 6 Bbl of oil, leaving a surplus of just under 0. 1 Bbl at the end of the year. In the United States, one of largest consumer markets for oil and oil products, from the first week in September 2004 to the first week in September 2005, gasoline prices increased by a staggering $1. 22 per gallon to $3. 12 before dropping to $2. 25 on November 21, 2005. These figures are quite staggering considering that contracts for crude changed hands at 10 USD/barrel in 1999. With the emergence of China in the global market and its increasing demand for oil, it is projected that unless oil companies are able to increase the world production by investing investment in oil and natural-gas production oil prices could increase exponentially over the next ten (10) years. The obvious factor in determining the supply of oil in the world is the amount of oil that can actually be extracted and processed. Oil is essentially a non-renewable energy source and cannot be replenished once it has been extracted from the ground. The role of oil companies and countries is not in the actual production of oil but in it rationing. A network of scientists called the Association for the Study of Peak Oil and Gas (ASPO) which is affiliated with a wide array of global institutions and universities studies the depletion rate of oil. ASPO studies concern themselves in determining the date and impact of the peak and decline of the world’s production of oil and gas, due to resource constraints. The ASPO uses the â€Å"Peak Oil Theory† or the â€Å"Hubbert Peak Theory† which is a method of modeling known oil reserves and production rates and routinely used by oil companies to predict future yields of existing oil fields (Legget, 2005). Using this model, it has been projected that the world oil production growth trends, in the short term, have been decreasing over the last 18 months. Average yearly gains in world oil production from 1987 to 2005 were 1. 2 million barrels per day (mbbl/d) (1. 7%). Global production averaged 84. 4 mbbl/d in 2005, up only 0. 2 mbbl/d (0. 2%), from 84. 2 mbbl/d (13. 4 million m? /d) in Q4 2004 (Legget, 2005). ASPO predicts that conventional plus unconventional oil production will peak around 2007 What this data basically means is that the current supplies of oil all over the world are being depleted and newer sources have not yet been discovered. To bring the supply of oil up again, oil companies must invest more in locating more oil fields and also develop new technologies to improve the current refining processes to allow for a more efficient production of oil. This first factor in the supply of oil is basically dependent on the actual amount of oil that can be produced and processed and also considers the capacity of oil companies to refine oil more efficiently and to tap other sources of oil (Deffeyes, 2005). This factor however also heavily depends on the capital investments that oil companies make in the oil industry. One of the main factors which affect the demand for oil is the price of oil. But given the fact that oil is a necessary resource and that it is a non-renewable energy sources, the supply can basically only remain at a certain â€Å"Peak† level depending on the amount which can actually be processed and the demand also remains at a certain level even if oil prices continue to rise (Case, 1999). Ordinarily, if the resources were renewable, there would be perfect elasticity between the supply and the demand in proportion to the increase or change in the price. Therefore, if the price of oil were to increase, it would theoretically result in the demand for oil to decrease (Case, 1999). This assumption however cannot be applied to the case of oil because, as mentioned earlier, oil is a non-renewable resources and remains as the primary source of energy in the world today. This shows the inelastic demand for oil. The reason for this is that since oil remains the main energy source in most countries, the demand for oil will remain constant despite the changes in the price of oil (Case, 1999). While theoretically it is expected that there will be a greater demand for oil if the price decreases, it is important to factor in the fact that more governments around the world are implementing energy saving policies as well as trying to reduce to dependence on oil as an energy source by developing alternative sources of energy (hybrid cars, solar power, hydroelectric power) (Simmons, 2005). The fact that oil is a non-renewable resource must also be considered. The next factor which affects demand for oil is the availability of alternative energy sources which are cheaper (Bilgen, 2004). The presence of substitutes in a market allows the demand for oil to decrease if the price continues to increase (Case, 1999). Before discussing this factor, it is important to remember that the development of alternative energy sources is not in proportion to the increasing rate of demand for oil. The presence of substitutes in a market affects demand because any increase in the price of the commodity means that the consumers have an alternative and can lower their demand for the commodity and purchase the substitute instead (Case, 1999). The same principle applies for oil except that it must be remembered that the development of these substitutes or alternative sources of energy takes a considerably longer amount of time than conventional substitutes. However, under the assumption that there are already alternative sources of energy available in the market, it can be expected that the demand will react accordingly to any increase in the price of oil. The dependence on oil as an energy source will decrease thus reducing the demand for oil in proportion to the price increases (Pimentel, 1998). The challenge remains however for countries and governments to find ways to find alternative energy sources to reduce the world dependence on oil as an energy source and ease the burden that the increasing prices have on the consumer. While the government may effectively regulate its use, the best solution is still in the development of energy substitutes for the market (Pimentel, 1998). Other factors which also have an effect on the demand for oil are things such as the government regulations on the use of fossil fuels, energy saving campaigns and environmental regulations. The government can implement these measures by increasing taxes or imposing fines. The effect that this has on demand is simple. The government regulations effectively reduce demand because the consumers are restricted from buying more oil. By encouraging the implementation of energy saving policies, oil consumption is also greatly decreased thus affecting the demand. The demand for oil therefore is affected by many factors such as price, availability of substitutes, and government intervention in the form of taxes, energy regulations and price controls. References: Bahree, B. (2006) Investment by Oil Industry Stalls November 8, 2006 Wall Street Journal November 2006 Bilgen, S. and Kaygusuz, K. (2004) Renewable Energy for a Clean and Sustainable Future, Energy Sources 26, 1119 Case, K. and Fair, R. (1999). Principles of Economics (5th ed. ). Prentice-Hall Deffeyes, K. (2005). Beyond Oil: The View from Hubberts Peak. Hill and Wang publishing House. Hill and Wang United States Leggett, J. (2005). The Empty Tank: Oil, Gas, Hot Air, and the Coming Financial Catastrophe. Random House. Pimentel, D. (1998). Energy and Dollar Costs of Ethanol Production with Corn Hubbert Center Newsletter, 98/2. M. King Hubbert Center for Petroleum Supply Studies, p. 8. Simmons, M. (2005). Twilight in the Desert: The Coming Saudi Oil Shock and the World Economy. Random House

Woolworths Overview Of The Company Marketing Essay

Woolworths Overview Of The Company Marketing Essay Its core business focus is the provision of retail and financial services to upper and middle income groups mainly in South Africa but also in Africa, Australia and New Zealand.  This includes men, women and kids. Who are the competitors in the market? Other retailers selling food (butchers, bakers, convenience stores, etc. excludes takeaway food and restaurants) Mass merchants (including discount department stores; department stores) Size of the company Woolworths Holdings Limited is an investment holding company and one of the top 100 companies listed on the Johannesburg Securities Exchange Shares in Woolworths: 52% of market Employees:  24,649 Stores:  637 Turnover:  R 25.582bn p/a Market share: 9%-10%   Vision: Woolworths vision is to provide quality products and services to its customers all the time through price strategies, fresh food strategies and human resource strategies. Woolworths main strategies are to increase efficiency and be cost effective. Mission: Woolworths mission statement and main strategy is to deliver to customers the right shopping experience each and every time. Goals Sustainable growth within the context of the changing social and environmental needs Woolworths goal is to work harder to drive social development poverty drives environmental destruction and that in turn creates more poverty. To help alleviate poverty, we need to expand the existing initiatives of the Woolworths Trust and link with the transformational goals to drive enterprise development. The third priority relates to Woolworths impact on the environment, in particular the issue of diminishing biodiversity.   The fourth priority addresses climate change directly by focusing on reducing Woolworths carbon footprint. Woolworths recognizes climate change as an issue requiring urgent action if the risk of serious damage to global prosperity and security is to be avoided. Strategy: The strategic intent considers four areas of focus: the customers, operations, and the people. Woolworths main strategy is to increase efficiency and be cost effective.   Under this strategy there are different strategies that the company uses such as price strategies, fresh food strategies and human resource strategies/growth strategy. QUESTION 2 What would you change? What parts of the strategy? Low price Strategy: (high quality vs. low price) I would change the current pricing structure as it gives negative perception about the quality of their products. For consumers to believe that they offer high quality, price must be slightly more than usual as it creates a value-add considering the input costs. Product Strategy: (healthy organic foods) I would increase the percentage of organic food in the stores to increase/promote healthy eating. Growth strategy: (entering new markets) The stores are currently situated in high economic areas. I would therefore introduce Woolworths into low to medium income earners in different locations. Why would you change it? (What internal/external forces?) Low price Strategy: (high quality vs. low price) Because the input (fixed variable) costs have to be considered in order for the value added to be fairly presented so that the company can also see a good profit depending on the area of location. E.g. a Woolworths store in Cape Town will differ in prices to a Woolworths store in Mitchells Plain. Product Strategy: (healthy organic foods) When a big amount of customers consume a lot more of organic products, the will relate to Woolworths as the healthy alternative. Growth strategy: (entering new markets) This will give everyone the same shopping experience and affording them a chance not to travel too far for shopping. Safety strategy: When this is implemented in families, it can have a multiplying effect and reach a lot of people within a short period. Financial Services: (credit cards personal loans) Both cards allow customers to earn W points. Therefore, it is not necessary to have cards instead of one. One stop shop: (sells a variety of things) I would focus only on one or two offerings as too many products create confusion regarding the real product offering. QUESTION 3 How would you change it? Low price Strategy: (high quality vs. low price) I would push the price a bit higher because the high quality does not match the price. I would include all costs, improve packaging and set a higher mark-up. Product Strategy: (healthy organic foods) I would get more suppliers of organic food on board and attract more healthy-conscious customers as well create more awareness on healthy eating and how it impact on effective leadership. Growth strategy: (entering new markets) I would introduce more Woolworths stores in medium income areas first. Then, I would roll it out to low income areas (townships) such as Khayelitsha. Advantages My strategy achievement in terms of company goals Low price strategy: one of Woolworths main strategies is to increase efficiency and be cost effective. The advantages of our strategy, the high price high quality strategy, would allow the quality of Woolworths goods to be high all the time. There will be less costs going into the research and implementation of many of the many strategies for Woolworths, to allow for the high quality low price strategy. It will also be less time consuming for Woolworths and Woolworths is known in the past for having high prices. People still have the perception of Woolworths having high prices. Product Strategy: Because they have allowed for these high prices they are also able to increase the percentage of organic foods. This is obviously good for healthy eating habits and maybe in the long term decreasing the unhealthy eating disease rate in South Africa. Woolworths can also create healthy eating plans for individuals to increase buyers for the company. Growth strategy: (entering new markets) the advantage of this would be to increase the Woolworths clientele. This would allow for many other buyers to experience the Woolworths experience. Safety strategy: The advantages of this would be promoting the good ethics of the Woolworths Company. Financial Services: the advantage of merging the visa and the difference cards would allow for efficiency when coming to the till at a Woolworths store. You will be able to have the choice on which transaction you would like to use. This will allow for more customers to get involved with both choices. Having one Woolworths card with both options is better than having two cards. One stop shop: The advantages of having all these products is that it caters for all needs. This also allows the company to use a variety of promotion techniques to get through to their customers. Disadvantages Low price strategy: At the moment times are tough and people are still suffering from the last recession. To increase the prices could make the company have a bad name. The main reason they decrease the price is to give everyone the chance to have the Woolworths experience and be in the same level as their competitors offering goods at better quality. So increasing the price could steer the customers away although a slight increase wont really affect the customer too much because of the quality of their products. Product strategy: Costs of these organic goods are expensive and the company is already trying very hard to keep high quality goods at low prices. Growth Strategy: Woolworths prices are higher than the usual Shoprite. Many people in low earning areas tend to go to Shoprite but there quality of food is not as good as Woolworths. People in low income areas are not really interested in quality and they are more interested in price. I feel it is a disadvantage to put a Woolworths store in low income areas because they will not make enough money to keep the store going. Maybe they could increase the amount of stores in the medium earning areas but still this would be a far reached goal to bring it in the low earning areas. The price of the goods is just too high. Safety strategy: Because this is seen as part of work. Most workers wont want to waste their time extending this technique to their families. It will be seen as extra work to be done. Financial services: this will be time consuming for the company and there will be costs involved to implement this strategy. One stop shop: Woolworths has already made itself known for having all these products but some products are more known to their customers then others. Woolworths needs to have their other products, like homeware, better promoted. Having all these products is the store can be costly. People will rather choose to go to Mr. Price home than to buy homeware appliances at Woolworths. Woolworths needs to strengthen their market in there other products or they will be losing profits. Conclusion Woolworths strategy works very well. It works so well that I feel these small changes wont make much of a difference because they know what they have and they know where they are in the market. They were able to change their strategy over the years and even by doing so it has made them even more successful. This is the reason I feel there strategy is well implemented. QUESTION 4

First Gov Analysis :: essays research papers

FIRSTGOV.COM VERSUS CANADA.COM I compared the United States FirstGov.Com portal page with our neighbor Canada’s government portal page. I first looked at firstgov.com to get a feel for the United States government page. When you first open http://www.firstgov.gov/ you immediately notice that there is an abundance of information. There are four main tabs set up as the main crux of the web page and those are: For Citizens, For Businesses and Non Profit, For Federal Employees, and Government to Government. Right off the bat renewing a drivers license and passport application is what jumped out to me personally. These were under the, â€Å"Citizens Get It Done† heading. Also, under this heading were links that direct you to e-filing taxes, checking immigration status, governmental benefits, government job application procedures, changing your address, and even shopping at government auctions. At mid page on the For Citizens tab was a section entitled, information by topics. There are 14 main topics and when you click on one of them it sends you to another link that has numerous other topics that a user can click on for almost any kind of information you can imagine. For example: I clicked on Education and Jobs topic. Under the topic is brief information on what you can find such as employment, training, careers, labor, wages, workplace, online learning, schools, student and teacher resources...This led me to a page that has well over 70 links to other topics. A few examples here are : US Dept of Labor, US Dept of Education, College Search, Disability Information, Career Choices, Labor Relations, and many more subjects to look up. Each of these links takes you to other pages full of related information with more links to follow.   Ã‚  Ã‚  Ã‚  Ã‚  What I found interesting also was you can read this web site in almost any language. I clicked on Spanish and the entire web page converted to Spanish. Also on the left hand side of the home page is a small index with links entitled: A-Z agency index, Federal Executive, Federal Legislature, Federal Judicial, Cross agency portals, state government, local government, and tribunal government. I chose to look at Federal Legislature and that takes to a page where you can find out information on the US Senate, US House of Representative, and agencies that support Congress. An abundance of information in all areas in the index.   Ã‚  Ã‚  Ã‚  Ã‚   When you go to Canada’s web site, http://www.

Dance with the Music :: essays research papers

When we think of gifts, we picture little boxes covered with shiny wrapping paper and a cute little ribbon on top. For my fifth birthday, my present didn’t exactly fit these â€Å"requirements†.   Ã‚  Ã‚  Ã‚  Ã‚  Sitting down in front of the piano every night, I can remember the time when one little girl’s dream came true. Immediately after I woke up on the day of my fifth birthday, my parents blind-folded me and led me to the dining room. Taking off the handkerchief, I stood in front of the most beautiful piano I had ever seen. In front of me was a brown, upright Wurlitzer, my very own piano. I immediately pulled out the chair from under the piano and opened the lid. I took a deep breath and played Jingle Bells, the only song I could memorize at the time. Gliding my fingers over the smooth piano keys, I couldn’t believe that this was actually happening.   Ã‚  Ã‚  Ã‚  Ã‚  Turning five, I was only interested in music. While other children would sit in front of their televisions and bug their eyes out watching Barney and Sesame Street, I became engrossed in watching tapes of ballets, concerts, and musicals. It was evident that I was a child who would grow to love music and its art; however no one could ever imagine that this interest would evolve into a significance that would change my childhood forever.   Ã‚  Ã‚  Ã‚  Ã‚  At around the same time, I realized that my cousin Caroline was my role model. She was a tall girl that would blow people away as soon as she stepped into a room; you could sense her magnificence from a mile away. Caroline was attracted to just about everything that I was, and excelled at all the things that she attempted, which included the art of piano. Once I learned that she was such a brilliant musician, I started to beg to learn how to play the piano. Most of my family members thought that this was just some childhood stage that I would quickly get over and drop.   Ã‚  Ã‚  Ã‚  Ã‚  My mother brought me to my first keyboard teacher, Scott. He taught me about all the essentials including the notes, their values, and some simple songs. Although I learned nothing more then the basics, I was overjoyed, treating the uncomplicated steps as gold. Every week after lessons, I would rush to my parents, skipping with delight, eager to show them what I had learned.

Psoriasis

Yes, psoriasis can be treated This six-part KULIT article series by the Persatuan Dermatologi Malaysia aims to raise awareness of psoriasis. In this final article, PDM President Dr Allan K C Yee highlights an important message for people with psoriasis – there is no cure yet for psoriasis, but its symptoms can be effectively treated and managed. Be open-minded and willing to work with your doctor to find a treatment that will work for you. The object of treatment is to reduce the extent and severity of psoriasis – the red scaly stigmata, the tell-tale scaling on one’s clothes, the rough cracked palms that make handshakes awkward, painful joints that limit one’s activities. In short, the goal is to improve the quality of life which has been shown in studies to be as affected as much as other major diseases such as cancer, heart disease and depression. The good news is that with today’s medical armamentarium, much can be done to allow the sufferer a greatly improved quality of life. Treatments must be individualized Fortunately, only 20% of psoriatics suffer from severe psoriasis, and the site involved is so variable that the treatments must be individualized. Limited disease can be treated with topical agents but more extensive skin involvement will require oral systemic treatments, phototherapy with artificial UV light, or even injectable agents (biologics). Furthermore psoriasis can affect any part of the body, each meriting special measures. Site-specific treatments For instance, thick scalp psoriasis is often mistakenly treated with endless anti-dandruff shampoos with little results. Scalp psoriasis invariably responds dramatically to tar pomades under occlusion for one to two weeks, a tip that an experienced dermatologist would gladly share with sufferers. Similarly, thick and cracked scaly palms and soles that prevent working with the hands or sometimes even walking, can be significantly improved with special steroid-salicylic acid ointments used under occlusion. These soften and shed the thickened dead skin making the skin pliable and usable once more. Psoriasis affecting the face, body creases – groins, armpits and private areas can be improved with the udicious use of weaker topical steroids and the newer and safer nonsteroidal calcineurin-inhibitors. The problem is that these thinned skinned areas are often treated with strong steroid creams that are not meant to be used in these sensitive areas. The end-result is irreversible side-effects such as ugly pink stretch marks, easy bruising and skin infections. We see a lot of these unfortunate cases who are sold these strong steroids from errant pharmacies without a prescription, or are introduced to them by well-meaning friends and relatives. The Dermatological Society of Malaysia is working with the Ministry of Health to ensure that potent steroids are only available with a prescription. The treatment should not be worse than the disease! Hopefully with warnings such as in this article, the lay public will be better informed about the dangers of self-medicating with potent topical steroids. Topical Treatments Generally, when the extent of psoriasis is limited to less than 5 – 10% of the body surface area (BSA), it is best to use topical treatments in the form of creams, ointments, lotions. As a guide, 1% of the BSA is the area covered by one’s palm. The red, thickened skin in psoriasis is due to the increased multiplication of the skin, allowing the collection of the dead skin layer to be manifested as thick scales. Most effective treatments whether topical or systemic work by reducing the cell multiplication, and by removing the dead skin layers. Time tested agents are coal tar, and anthranols which are messy and brown-staining thus adding further to the stigmatization sufferers feel. More cosmetically acceptable topical agents are steroid creams, vitamin D analogues and calcineurin inhibitors. The latter two are more expensive than the ubiquitous steroid creams but with a superior safety profile. Most psoriatic lesions also tend to be dry and glycerin, urea-based or other humectant moisturizers help relieve soreness and improve recovery especially when used in conjunction with keratolytics – agents that soften and shed the abnormal dead skin layers. Systemic treatments When more than 10% of BSA is involved it becomes impractical to rely on topical measures alone. It may take more than half an hour just to apply creams on large areas of affected skin. Hence, oral or injectable medications are required. Many of these drugs are able to reduce the skin’s cell multiplication or maturation rate eg methotrexate, hydroxyurea, retinoids. However many others suppress the disease process at a more fundamental level by suppressing the activity of abnormal white cells (T-cells) or by neutralizing the T-cells inflammatory chemicals (eg TNF a) eg cyclosporine and the newer biologic agents licensed for use in Malaysia. With the proper use of these systemic agents singly or in combination, it is often possible to control even the most severe cases of psoriasis. However, these systemic agents should only be used by experienced physicians as many of them can have significant side effects. For example, persons with liver disease or gastric ulcers should not be treated with methotrexate; women of child-bearing age should not use retinoids as it can cause fetal abnormalities; persons with high blood pressure or kidney problems cannot use cyclosporine. If a person with severe psoriasis has liver disease, is a woman of childbearing age, or has kidney problems what options then are available for him/her? There are 3 options – oral salazopyrine which only works in 50% of Asians, the injectable biologic agents, or phototherapy (see below). Biologic agents are the new kids on the block. They have a much better safety profile than the above mentioned oral drugs and can be used in persons with liver, kidney disease and women but unfortunately their high cost means relatively few can afford them. Even in the west, where such expensive treatments are reimbursable, the psoriasis must be shown to be non-responsive to conventional oral drugs, or organ toxicities with these drugs are present. Some of them are very helpful in controlling psoriasis as well as the disabling arthritis that affects 10-30% of psoriatics. Phototherapy (PUVA, UVB, nUVB) This is an excellent form of treatment with artificial UV light which is relatively free from serious side effects apart from a small risk of developing non-melanoma skin cancers with prolonged use. This risk is probably not significant in the setting of Asian skin types especially with the newer types of phototherapy equipment such as narrow band UVB (nUVB), and the excimer laser or excimer light. Another advantage of phototherapy is that it is a clean form of treatment, nonmessy and can give a long remission period of up to one year. The main drawback is that it does require visits to the phototherapy centre 3 times a week for 2-3 months. The good news is that most states in Malaysia now have phototherapy units to treat not only psoriasis, but also vitiligo and severe atopic eczema. Alternative therapies In this day and age where the emphasis is on evidence-based medicine (EBM), alternative therapies must prove its worth with hard core scientific evidence from well-conducted clinical studies. Many people with psoriasis who have suffered from the condition for years are, not surprisingly, hopeful for answers, breakthroughs, and even a â€Å"cure† perhaps. Unfortunately, there is no shortage of charlatans offering â€Å"cures† for psoriasis, often in network marketing schemes. One has to acknowledge the fact that psoriasis has a genetic basis, and unless gene therapy becomes a reality, there cannot be a cure, even with accepted treatments such as climatotherapy in the Dead Sea. Diets for psoriasis are as yet unproven, although an FDA-approved healthy diet with at least 5-9 servings of fresh preferably organic produce may be of help in improving one’s general health. Stress reduction strategies may help insofar as stress precipitates and aggravates psoriasis. Prayer has been shown useful in several medical conditions, and a strong faith life can only help, if only to give one the equanimity to deal with the turbulence of modern life. The future of psoriasis treatments There is considerable optimism in the search for better and safer treatments for psoriasis in the near future. We now have a much better understanding of the genetics and underlying immune derangements in psoriasis. It is only a matter of time before the tremendous amount of ongoing research bears better fruit that is sweeter and without the bitter aftertaste of side-effects. Indeed here are promising smaller molecules in the offing that are cheaper to synthesize. Watch out for this space. Psoriasis affects 2-3 percent of Malaysians. This is the final article of a six-part series from PDM’s â€Å"KULIT – Living with Psoriasis† Campaign 2007. For more on psoriasis, treatment options and KULIT, visit www. dermatology. org. my or email [email  protected] com. This article is a guide to help you better understand psoriasis and psoriatic arthritis. Consult a suitably qualified medical practitioner before acting on any information contained above. KULIT is a community programme sponsored by Wyeth Malaysia.