On June 5, 1998, a meeting was held at Hyten Corporation, between Bill Knapp, director of sales, and John Rich, director of engineering. The purpose of the meeting was to discuss the development of a new product for a special customer application. The requirements included a very difficult, tight-time schedule. The key to the success of the project would depend on timely completion of individual tasks by various departments. Bill Knapp: "The Business Development Department was established to provide coordination between departments, but they have not really helped. They just stick their nose in when things are going good and mess everything up. They have been out to see several customers, giving them information and delivery dates that we can't possibly meet." John Rich: "I have several engineers who have MBA degrees and are pushing hard for better positions within engineering or management. They keep talking that formal project management is what we should have at Hyten. The informal approach we use just doesn't work all the time. But I'm not sure that just any type of project management will work in our division."

111 Is the use of amlodipine or furosemide recommended to normalize blood pressure in a case of hypertensive heart failure? If so, which is most effective?

112 How can diabetes cause endothelial dysfunction? What are the roles of ACE inhibitors in the kinin-kallikrein system? What are the mechanisms by which a decrease in the level of nitric oxide causes endothelial dysfunction?

113 Can sublingual nifedipine be given to a patient with malignant hypertension/accelerated hypertension? It seems to be a controversial issue with some favouring it and some against it.

114 Is the diagnosis of malignant hypertension based only on the basis of the retinopathy (even in the presence of a normotensive state)? Labetalol, parenterally, is suggested as a treatment for malignant hypertension. What other more readily available preparations (besides sodium nitroprusside) are recommended in addition to this drug? Parental labetalol is not available in Pakistan!

115 Patients at medium risk of DVT and pulmonary embolism are usually given specific prophylaxis with low-dose heparin at a dose of 5000 units subcutaneously every 8-12 hours until the patient is ambulatory. Is the first dose given immediately after, say, extensive varicose vein surgery of small and great saphenous veins?

116 'Anticoagulants are not necessary, as embolism does not occur from superficial thrombophlebitis' (K&C 7e, p. 809). Why?

117 Can we use enoxaparin for deep vein thrombosis (DVT) prophylaxis in the immediate postoperative period and in a case of cerebral haemorrhage? Wouldn't it increase the risk of haemorrhage in either case?

118 Can external jugular vein thrombosis cause tingling numbness over the earlobe and adjoining part of the lower face?

119 For how long does a patient have to stay in bed to be labelled as bedridden and to merit low-molecular-weight heparin (LMWH) as prophylaxis for deep vein thrombosis?

120 Is an inferior vena cava filter an alternative treatment for a patient with a history of recurrent deep vein thrombosis on lifelong anticoagulation with warfarin?