Cross cultural comparison of Automobile Dealerships between UK and India in the light of Market Orientation and Internal Market Orientation.

Sales managers are charged with the task of increasing sales whilst at the same time maintaining customer satisfaction. A primary method advocated in the literature to achieve this is market orientation; a construct which places the customer central to the operations of the firm and is designed to collect information to understand the customer and so tailor the product-service offering to best meet their needs. However, additional study into internal market orientation (sometimes known also as employee orientation) implies that sales people will not treat customers in this way if they too do not feel a valued part of the organisation. At present, there is little research into how a firm can use both a market orientation and an internal market orientation to optimize the sales strategy. This study attempts to resolve this gap by developing a conceptual model of their relationship which is then explored through a set of interviews with sales executives in the UK and a comparable set in India to examine for international and cultural differences. It is found that implications are offered as well as avenues for future research. By and large, the main conclusion is that the long-run success for an organization is backed by sales performance which has direct relation with the sales executives

Cross cultural comparison of Automobile Dealerships between UK and India in the light of Market Orientation and Internal Market Orientation.

Sales managers are charged with the task of increasing sales whilst at the same time maintaining customer satisfaction. A primary method advocated in the literature to achieve this is market orientation; a construct which places the customer central to the operations of the firm and is designed to collect information to understand the customer and so tailor the product-service offering to best meet their needs. However, additional study into internal market orientation (sometimes known also as employee orientation) implies that sales people will not treat customers in this way if they too do not feel a valued part of the organisation. At present, there is little research into how a firm can use both a market orientation and an internal market orientation to optimize the sales strategy. This study attempts to resolve this gap by developing a conceptual model of their relationship which is then explored through a set of interviews with sales executives in the UK and a comparable set in India to examine for international and cultural differences. It is found that implications are offered as well as avenues for future research. By and large, the main conclusion is that the long-run success for an organization is backed by sales performance which has direct relation with the sales executives

Dexmedetomidine provides optimum conditions during awake fiberoptic intubation in simulated cervical spine injury patients

Background and Aims: We undertook this study to assess if a small-dose of dexmedetomidine (DEX) for conscious sedation during awake fiberoptic intubation (AFOI) in simulated cervical spine injury (CSI) patients provides optimum conditions and fulfills the need of postintubation neurological examination required in such patients. The aim was to assess the efficacy of DEX on arousability and patient′s comfort during AFOI in simulated CSI patients. Material and Methods: In this prospective, randomized double-blind study, 100 American Society of Anesthesiologists Grade I-II patients aged between 18 and 65 years scheduled for elective surgery under general anesthesia underwent AFOI under conscious sedation with DEX. After locally anesthetizing the airway and applying a cervical collar, patients either received DEX 1 μg/kg over 10 min followed by 0.7 μg/kg/h maintenance infusion or normal saline in the same dose and rate during AFOI. Targeted sedation (Ramsay sedation score [RSS] ≥2) during AFOI was maintained with midazolam [MDZ] in both groups. Statistical Analysis was performed using unpaired Student′s t-test, Chi-square test, Mann-Whitney test and Wilcoxon-w test. Results: The total number of patients requiring MDZ and the mean dose of MDZ required to achieve targeted sedation (RSS ≥2) was significantly less in DEX group compared to the placebo group (P < 0.001 ). Similarly, patient satisfaction score, heart rate, systolic, diastolic and mean arterial pressure and respiratory parameters were significantly better in DEX group (P < 0.001). Postintubation arousability in the two groups was comparable (P = 0.29). Conclusions: Dexmedetomidine provides optimum sedation without compromising airway or hemodynamic instability with better patient tolerance and satisfaction for AFOI. It also preserves patient arousability for the postintubation neurological assessment

Aortic atherosclerosis: a common source of cerebral emboli, often overlooked!

Aortic atherosclerotic plaques are usually seen in males older than 55 years who are known to have risk factors of atherosclerosis. Recent large series of consecutive stroke patients reported that the prevalence of aortic atheromatous plaques in patients with stroke is about 21%-27%, which is in the same magnitude when compared with the prevalence of carotid disease (10%-13%) and atrial fibrillation (18%-30%). Atheromatous plaques are composed of a lipid pool, a fibrous cap, smooth muscle cells, and mononuclear cell infiltration with calcification. Aortic plaques can cause embolization to brain, extremities, or visceral organs. Atheroembolization can occur spontaneously or as a result of manipulation during cardiac or vascular surgery. Only few cases of cerebral embolization from an aortic plaque in the absence of any manipulation have been described. Although few atherosclerotic plaques can be visualized on the aortogram, transesophageal echocardiogram remains a preferred modality for diagnosis in such cases. We present a case of cerebral embolism arising from a mobile noncalcified complex aortic arch plaque diagnosed on a transesophageal echocardiogram and review the literature on its diagnosis, clinical implications, and management

Predictors of short-term outcomes in patients undergoing percutaneous coronary intervention in cardiogenic shock complicating STEMI—A tertiary care center experience

Background: Studying the outcomes in patients presenting with cardiogenic shock with ST-segment elevation myocardial infarction (CS-STEMI) and undergoing primary or rescue percutaneous coronary intervention (PCI) may give an insight to the unmet needs in STEMI-care in our region and may help in future recommendations in improving survival. Materials and methodolgy: During the period from January 2001- June 2017, there were 114 patients included in the study. The demographic, clinical and angiographic characteristics were compared between the survivors and non-survivors. All these variables were also compared between two-time frames (Phase 1- January 2001 to June 2007; Phase 2- July 2007 to June 2017). Results: Among patients undergoing PCI for STEMI, 7.5% were in cardiogenic shock. In-hospital mortality for the patients included in the study was 53.5%. Total ischemic time (OR = 0.99, 0.99–1; p = 0.02), left ventricular ejection fraction (LVEF) (OR = 0.90, 0.82–0.98; p = 0.02), need for cardio-pulmonary resuscitation (OR = 0.12, 0.24–0.66; p = 0.01), and post PCI TIMI flows (OR = 0.08, 0.02–0.29; p < 0.001) were the significant determinants of in-hospital mortality in the regression analysis. There was no significant change in mortality between the two phases of the study, though there was a reduction in total ischemic and door-to-balloon times, transfer admissions, use of thrombolytics, glycoprotein IIb/IIIa inhibitors, intra-aortic balloon pump, and mechanical ventilation in phase 2. Conclusion: Patients presenting in CS-STEMI and undergoing PCI continue to experience high mortality rates, despite improvements in total ischemic times. Further improvement in the systems-of-care are required to bring about reduction in mortality in this high-risk subset. Keywords: STEMI, Cardiogenic shock, Primary PCI, Mortality, TIMI flo