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The pathogenesis of chronic inflammatory demyelinating polyneuropathy (CIDP) remains highly debated among experts. In recent times, literature has divulged a riveting yet plausible association between colorectal carcinoma and CIDP as its paraneoplastic ramification. Initially, research suggested that chronic inflammatory demyelinating polyneuropathy (CIDP) was caused solely by macrophages. However, recent studies have insinuated towards an alternative pathogenesis, one involving autoantibodies against paranodal junction proteins. These two distinct mechanisms are the primary contenders responsible for the development of CIDP, rendering it an elusive paraneoplastic manifestation of colorectal carcinoma.

Amid the coronavirus disease 2019 (COVID-19) pandemic, there is an unprecedented increase in public avoidance of hospitals predominantly driven by fear of contracting the virus. Recent publications highlight a re-emergence of rare post–myocardial infarction complications. While mechanical complications are infrequent in the era of primary percutaneous coronary intervention, they are associated with high mortality rates. The concurrent occurrence of mechanical complications such as left ventricular aneurysm and ventricular septal rupture is an extremely rare entity. We hereby delineate a unique case of a 53-year-old Caucasian male who underwent successful concomitant closure of a ventricular septal rupture, left ventricular aneurysmectomy, and 3-vessel coronary artery bypass grafting. Due to a delayed initial presentation owing to the patient’s fear of contracting COVID-19, the surgery was carried out 3 months after the myocardial infarction. His postoperative evaluation confirmed normal contractility of the left ventricle and complete closure of the ventricular septal rupture. Six months postoperatively, the patient continues to do well. We also present a literature review of the mechanical complications following delayed presentation of myocardial infarction amid the COVID-19 pandemic. This article illustrates that clinicians should remain cognizant of these extremely rare but potentially lethal collateral effects during the ongoing global public-health challenge. Furthermore, it highlights a significant concern regarding the delay in first medical contact due to the reluctance of patients to visit the hospital during the COVID-19 pandemic.

Background Necrotizing enterocolitis (NEC) is a debilitating disease that predominantly afflicts premature neonates, although it can also affect term neonates. The clinical features of the ailment vary widely and range from transient feed intolerance to life-threatening complications such as septicemia and disseminated intravascular coagulation. While surgery is usually only reserved for severe cases, such as those presenting with intestinal perforation, the role of surgical management in cases of NEC without perforation remains elusive. Methods A retrospective chart review of patients, three years in duration, was conducted and studied confirmed cases of NEC. The clinical presentations studied included cases of NEC with pneumatosis intestinalis, fixed bowel loop, pneumoperitoneum, and abdominal wall erythema. The patients were divided with regards to their intestinal perforation status and with pertinence to the treatment modality employed (medical or surgical). The results in either group were eventually analyzed in terms of the overall survival rate. Results A total of 48 patients were included in the study, of which 79.16% presented without perforation and 20.83% with perforation. Of the study participants included, 26 were females and 22 were males. Pertinently, no gender predominance was appreciated. In patients without perforation, medical management was noted to boast a lower mortality rate when compared with surgical intervention (15.6% vs 50.0%, respectively). In patients with perforation, the overall mortality was noted to hover at 50.0%, which was higher than that encountered in the non-perforation group. Conclusion In patients with NEC without perforation, surgical treatment confers no comparative therapeutic advantage when compared with medical management alone. Conservative management with broad-spectrum antibiotics including metronidazole yields equally favorable outcomes in such cases.

Introduction While tetanus has largely been eradicated with the advent of the tetanus vaccine, its prevalence in Pakistan remains alarmingly high due to insufficient uptake of the vaccination program. The clinical presentations that the disease elicits range from mere opisthotonos to more sinister complications, including respiratory failure and death, often posing an insurmountable challenge for hospitals. Methods A retrospective cross-sectional study was conducted and analyzed the medical charts of 43 patients with a confirmed diagnosis of tetanus infection. The charts were perused for the patients’ demographics, clinical characteristics, and disease outcomes. The prevalence of various clinical symptoms and complications were reported in terms of frequencies and percentages. Results The mean age of the patients hovered at 29.53 ± 16.53 years, with a range of 12 to 65 years. Of those affected, 83.7% were males while 16.3% were females. Notably, none of the infected patients had a prior history of vaccination against tetanus. Trismus was noted to be the most prevalent clinical manifestation and was found in 90.70% of the patients while paraesthesia at the site of infection, found in 6.98%, was the least prevalent. The overall mortality was noted to hover at 46.5%. Conclusion While tetanus has largely been eradicated, its prevalence in Pakistan remains alarmingly high. The complications noted in the study have implications for the country’s public health system and aims to better inform the current state of the national vaccination program.

The purpose of this research study is to explore the advance fundraising techniques in the non-profit, charitable, philanthropic organizations for the purpose of fundraising. This research study completed on the basis of primary data that is taken from NGO’s in the region of Punjab. Frequency distribution statistical technique is used in this research paper for analyzing the data. Data collection was completed through questionnaire, face to face interviews, telephonic interviews, survey through e-mails from the presidents of the non-profit organization and members of NGO which are working in the Punjab region. NGO’s such as Alpine Welfare, Umeed Welfare, People Woman Welfare Organization, Human development Form etc. were contacted for data collection. Fundraising is the management function. After the research we would be able to understand the advance fundraising techniques and methods. We have found the positive impact of technological media like YouTube, Face book, Twitter, and TV campaigns on the fundraising. In this research it is found that how donor’s relationship can create for fundraising. This research helps to the fundraiser for the fund generating. It gives a way to nonprofit charitable organization to increase their worth of money. The application of this research provides fundraising managers that is the good for any organization profitable or nonprofit able organizations.

In the modern societies, an increasing number of women are providing their services in different sectors of the economy such as business and industry, entrepreneurship, and more specifically in health and education sectors. Women are also serving their remarkable contributions as leader as men do. This study investigates the potentially competitive relationship between women and their leadership competencies and the challenges that women face during their professional responsibilities especially in case of any global disaster like pandemic COVID-19. Where the global crisis of the COVID-19 pandemic has greatly affected all fields of life at the same time, it has wide-ranging impact on the higher educational sector in South Asia, specifically in Pakistan. Due to the pandemic, all governments have either had to close HEIs or have transited their system to virtual learning. Countries like India, Pakistan, and Afghanistan realized that they are ill prepared for remote classes and online learning. In COVID-19, they need to manage HEIs effectively for the continuity of academic and research work.

COVID-19 put approximately all countries on lockdown. Libraries, whether they are public or private, also face closure. Through these closings, libraries remain to deliver facilities to their people in this perplexing period. So, this chapter discussed the challenges that libraries faced during this global health crisis and also discussed the possible applications that are helpful in these challenges. Data will be primary data used for empirical investigations and collected from public libraries of Pakistan. The chapter gives the empirical results or finding on the challenges (libraries closure, social distancing, handling material, and lack of research) and helpful applications like digital service, delivery services, exerted personnel, and online article requests for libraries. This chapter suggested applying quarantine strategies on returned books policy and implementing plans to offer remote services for example e-lending, e-learning, or support to remote teaching.

The antidiarrheal effect of methanolic extract of Trillium govanianum Wall. ex D. Don (Melanthiaceae alt. Trilliaceae) was studied at doses of 12.5, 25, and 50 mg/kg in different animal models of diarrhea including castor oil (6 mL/kg), magnesium sulfate (2 gm/kg), sodium picosulfate (2 mL/kg) and lactitol (0.25 mL/kg). The antispasmodic effect of T. govanianum was studied on isolated rabbit’s jejunum, using acetylcholine as tissue stabiliser and verapamil as calcium channel blocker. T. govanianum attenuated the diarrhea by producing a significant decrease in the number and weight of stool, and an increase in stool latency time. T. govanianum completely inhibited both spontaneous as well as high potassium induced contractions of isolated rabbit’s jejunum, which was analogous to verapamil. Moreover, T. govanianum produced a right shift in calcium concentration response curve, confirming its calcium channel blocking activity. These findings provide scientific ground to its medicinal use in diarrhea and gut spasms.

The Fourth Industrial Revolution is being implemented as technological revolution in every field of life. FIR has not only impacted the employees' behavior, well-being, and future of work but also brought a disruptive innovation everywhere. This chapter is beneficial for the reason that Fourth Industrial Revolution has affected the behavior of employees tremendously. With many opportunities from the fourth industrial revolution, rapid change, and excessive use of technology has stressed the employees. Digital transformation or era of digitalization has changed the future of work by automating the work performed by the human resource manually in the past. Automation of work is decreasing the labor requirement. Pressure of being unemployed and new skills learning after new technological change made employees' toxic. Fear of being unemployed and stress of earning new technologies has decreased the well-being of employees. This Fourth Industrial Revolution also has positive impact on the work and family life satisfaction by providing them the opportunities of remote and gig working.