Repositioning Virtual University of Pakistan

The purpose of this paper is to illustrate the concept of repositioning with a single case study design.  Case study selected for this research is the Virtual University (VU) of Pakistan. VU is the first Pakistani university based completely on modern information and communication technologies, was established by the Government as a public sector, not-for-profit institution. One of the challenges VU management faces as of now is regarding the perception of the university. Generally, VU is perceived as a sub-standard university and it is thought that only those who could not secure admission anywhere else have joined this institution. Secondly, masses have always been skeptical about the quality of education imparted at VU. The low fees are assumed to indicate poor quality of education and the government funding and subsidies are not considered as efforts to improve the standard of education in the country. VU has also signed a number of MOUs with top foreign and local universities, but these important associations have not been promoted effectively by VU so far.  Perhaps the greatest challenge surrounding the VU management is the consumer’s perception about the employability of VU graduates. This perception of masses about VU could have been changed by repositioning VU with an appropriately redesigned promotion campaign. Soon VU management realized the lack of advertising effectiveness and changed their positioning strategy. Three important changes they have made. Firstly, instead of targeting graduation ceremony or convocation, they moved towards Endorsements. They contacted their well-placed graduates in corporate sector and ask their endorsements. This was sensed immediately by the target audience and helped VU in enhancing their image.  Secondly they moved towards color advertisements in black and white classified pages which resulted in immediate recognition of their advertisements. Thirdly, they changed their program offerings and started offering 18-year MS degree programs which has resulted in enhancing consumer perceptions towards high quality education at VU. This capstone decision was proved fruitful measured by subsequent perception surveys. Keywords: Marketing, Positioning, Repositioning, Advertising Campaign, Services, University, Pakista

Lallemantia royleana Benth. (Balangu): A Compendious Review on Phytochemistry, Pharmacology and Ethnomedicinal Uses

Lallemantia royleana Benth. is an annual, biennial or perennial herb, belonging to the family Lamiaceae, commonly known as Balangu. It is cultivated throughout Western Asia, India, Pakistan and Northern of Iraq. In Unani system of medicine it act as a Mudire Baul  (Diuretic), Muqawwi Qalb (Cardiotonic), Musakkin (Sedative) etc and used for treatment of  Nazla wa Zukam (Common cold) , Humma (Fever), Dard Mafasil (Joint pain), Hudar (Rheumatism), Amraze Gurda (Renal disorder), Zofe Qalb (Weakness of heart) etc. Traditional observation reports that this plant retains potential to cure infectious diseases. Nowadays, it is receiving substantial consideration by scientist and pharmaceutical research industries with the aim to explore for more effective substitute. The seeds contain linoleic, oleic, betasitosterol, palmitic and stearic acids, its gums are composed of L-rhamnose, L-arabinose, D-galactose, protein, uronic anhydride and are generally used for the treatment of abscesses, inflammation and respiratory problems, also used in drinks due to its sedative effects. This plant seems to possess many undiscovered pharmacological properties which have to be explored. Keywords: Lallemantia royleana Benth, Unani medicine, Traditionl medicine

Malignant pheochromocytoma with widespread bony and pulmonary metastases

Pheochromocytoma is a rare benign tumor of the adrenal gland. A select few cases may be malignant, and metastatic cases are exceedingly rare. It often presents with symptoms of catecholamine excess, such as sweating, palpitations, headaches, and characteristic paroxysmal hypertension. Due to its diffuse symptoms, it is difficult to diagnose and is often diagnosed late. We describe the unique case of a 44-year-old female patient who presented with uncontrolled hypertension and vomiting, accompanied by lower back pain. She was diagnosed with malignant pheochromocytoma with multiple metastases to the lungs, vertebrae, scapulae, and skull. Because of the advanced state of her disease, the patient was started on treatment with the chemotherapeutic combination of cyclophosphamide, vincristine, and dacarbazine. However, she had a complicated hospital course and died because of aspiration pneumonia and sepsis

Prognosis of Severe Covid-19 patients after treatment with Therapeutic Plasma Exchange (TPE)

OBJECTIVE: To demonstrate the effective role of plasmapheresis in the treatment of Cytokine Release Syndrome associated with severe Covid 19 pneumonia. INTRODUCTION: Covid-19 disease is a deadly contagious disease with milder symptoms to a more severe form with acute respiratory failure, septic shock leading to even death. Literature study showed  that  in severe  Covid-19  patients, a hyper-inflammatory response  to  initial  infection could accelerate  to  severe  hyper-cytokinaemia that  could  lead to  an  underlying endothelial  dysfunction and multiple organ dysfunction. Thus, removal of these inflammatory cytokines by Therapeutic Plasma Exchange is considered to be an essential part of the treatment of critically ill patients in order to improve their survival rates. METHODOLOGY:  Retrospective observational study which included 150 RT-PCR positive patients admitted in Covid ITC, from the time period of 1st February 2021 to 31st July 2021 –removed for blind review---Data was analyzed using SPSS software version 16. Frequencies were calculated along with mean and standard deviation. Chi square and ANOVA test was applied to the data. P value <0.05 was considered statistically significant. Linear regression study was applied to predict the prognosis. RESULTS: Out of 150 patients, 51 patients (34%) were of severe ARDS category of whom 13 (25.5%) developed Cytokine Release Syndrome. They received plasmapheresis therapy subsequently and 7 out of those 13 (53.8%) patients got improved. P- value was found to be significant ( <0.05). Overall, the mortality rate was low with 120/150 (80%) getting discharged successfully. CONCLUSION:  Our findings suggest that Therapeutic plasma exchange is beneficial in Cytokine storm caused by SARS-CoV2 removing the inflammatory cytokines and improving symptoms, thereby, avoiding intubation. KEY WORDS: , Therapeutic plasma exchange, Hypercytokinaemia, Cytokine Release Syndrom

Exploring typical and atypical variants of celiac disease: a narrative review

There are many different clinical manifestations of celiac disease (CD), including the classical form, in which intestinal symptomatology predominates on the contrary there is atypical forms, in which extra-intestinal clinical features predominate, and the silent form, in which there are no clinical symptoms. Few or no gastrointestinal symptoms and a predominance of extra-intestinal features, including liver, kidney, skeletal, psychiatric, neurologic, dermatologic, hematologic, endocrinological, and reproductive involvements, define the atypical forms of the disease. Through screening high-risk groups, silent presentations of CD may be found. It is crucial for healthcare professionals to have a high level of suspicion for the atypical presentations of CD because it is now well known that CD may account for a number of chronic health issues

Extraction and estimation of iodine from brown seaweeds, of Karachi coast, Pakistan

Iodine is not only essential for thyroid function, but it is also beneficial for other organs of the body for example, prostate gland tissue, pancreas, gall bladder, kidneys, adrenals and even the liver. Brown seaweeds extracts are very rich in sea minerals with the supreme amount of iodine. In the present study, iodine was extracted from 6 different brown seaweeds representing three classes: Colpomenia sinuosa and Iyengaria stellata of class Laminarophyceae, Sargassum spp. of class Fucaceae, Padina pavonica and Spatoglossum variabile of class Dictyotaceae. The samples of Brown Seaweeds were collected from Buleji and Manora Rocky Ledges of Karachi coast. The level of iodine was measured in the range of 500ppm to 1000ppm by applying classical procedure. The maximum level was recorded in Sargassum carpophyllum and S. tenerrimum whereas the minimum was found in Padina pavonica

AN UPDATED REVIEW ON USTUKHUDOOS PLANT

Lavandula stoechas Mill. commonly known as Ustukhudoos, is perhaps the most important medicinal plant in the unani system of medicine. Whole part, flowers and essential oil of the plant is used to treat a variety of diseases. A number of ailments are treated by the plant which is used either alone or in combination with other plants. It is used for the treatment of various neurological disorders like hemiplegia, facial paralysis, tremors, epilepsy, melancholia, neurasthenia. Moreover, it is used in sinusitis, liver disorders and urinary disorders etc. L. stoechas possesses antimicrobial, antidiabetic, antioxidant, antifungal, anti-inflammatory, anticonvulsant, antispasmodic, sedative, hepatoprotective activities. This article discusses and summarizes the important medicinal values of Ustukhudoos in the perspective of Unani literature as well as modern scientific research. Keywords: Ustukhudoos, Lavandula stoechas, neurological, epileps

Tukhm Khashkhaash (Poppy Seeds): A Unani drug of multitudinous potential

Tukhm Khashkhaash is the seeds of Papaver somniferum belonging to the family Papaveraceae. The description of Poppy seeds is mentioned in various classical Unani books. Renowned Unani scholar Avicenna had also described poppy seeds in his famous book “The Canon of Medicine”. He wrote that Tukhme Khashkhaash safaid are the small white seeds obtained from the capsule of white poppy plant. The seeds which are obtained before the incision of capsules for the extraction of opium are considered to be of best quality. They are used since centuries for treating various ailments like diarrhea, dysentery, cough, premature ejaculation, chronic cough, insomnia and skin disorders as well as a nutritive food. Their antibacterial, anti-carcinogenic and hypoglycemic potential have also proved on scientific basis. In this review an effort have been made to collect the disseminated information and summarize the available data of the said drug

Evidence-Based Dentistry: Knowledge, Attitude and Practices Amongst Undergraduates/ Graduates of Karachi

Objective: The study aimed to evaluate the Knowledge, attitude, practices and perceived barriers of evidence-based dentistry amongst undergraduates/ graduates of Karachi. Setting: Dental College of Karachi. Study design: cross sectional study. Period: October 2019- March 2020. Material and Method: Amongst undergraduates and graduates of two dental colleges chosen at random from the list of dental colleges of Karachi. A pretested self-administered questionnaire was distributed to the participants. The questionnaire consisted of total 15 questions to assess Knowledge (6 questions), attitude, (5 questions) practices(3questions) and barriers (1 question) of evidence -based dentistry. Data was entered into SPSS version 22. Chisquare test was used to analyze the data. A mean score of Knowledge was obtained and different variables by using independent t-test and ANOVA as required. Pearson correlation was done to find correlation of knowledge score with variables. Results: A total of 342 participants responded to the questionnaire and there were 43.9% males and 56.1% females. Regarding age73.7% of the respondents aged between 20-25 years. Conclusion: The current study concluded that students and house surgeons were familiar with the term evidence-based dentistry when compared to the faculty members. The findings of the study also showed a positive attitude towards evidence-based dentistry

Role of Dexmedetomidine by Improving Sleep Quality and Pain Control in Covid-19 Patients

OBJECTIVE: To demonstrate the effective role of Dexmedetomidine as a sedative and analgesic agent in Covid-19 patients when used in conjunction with the established treatment of Acute Respiratory Distress Syndrome.  INTRODUCTION: Covid-19 disease is a deadly contagious disease with milder symptoms to a more severe form with acute respiratory failure, septic shock leading to even death. Literature study shows High Flow Nasal Oxygen therapy and prolonged prone position sessions to be beneficial in the treatment of ARDS, however, to facilitate those sessions, a sedative and anxiolytic agent must be added in the treatment. Therefore, this study was conducted to document the beneficial role of dexmedetomidine as a sedative agent.  METHODOLOGY: Retrospective observational study which included 150 PCR positive patients admitted in Covid ITC, from 1st February 2021 to 31st July 2021 residing in the premises of PAF Air Base, Mushaf, Sargodha. Data was analyzed using SPSS software.   RESULTS: Out of 150 patients, 120 (80%) were treated with High Flow Nasal Oxygen (HFNO), Dexmedetomidine infusion (DEXME) and long periods of prone position (PP) sessions. Among these 120 patients, 88 (73.3%) were discharged while 32 (26.67%) patients died of which 7 (21.875%) died while being on HFNO therapy and 25 (78.125%) patients were intubated. DEXME infusion was found to have a positive outcome (P-value <0.005) in the treatment of moderate to severe ARDS.  CONCLUSION: Our findings suggest that DEXME infusion is beneficial in moderate to severe ARDS caused by SARS-CoV2  when given along with HFNO therapy and prolonged PP sessions, thereby, avoiding intubation.