February 2019

Child abuse has negative outcome in children and adolescents that can extent into adulthood, which is a significant problem and needs an effective means of prevention. Child abuse comprises of a wide range of maltreatment including physical abuse, emotional abuse, sexual abuse and neglect. Increased number of child abuse case has been observed in the community. Among them children whose parents, especially mothers were not aware of the problems of child abuse. A Quantitative exploratory research was done with the objectives of assessment of knowledge of mothers regarding child abuse and to associate findings with the selected socio-demographic variables. The research design adopted for this study was descriptive design. The research study was conducted in selected rural area of Pune District. Data collection was carried out in the month of October, 2017. Sample of 100 mothers were taken. Tool used were questionnaire consist of two sections. First section included variables for age, level of education, occupation, type of family and age of youngest child were assessed. Second section included 15 items on knowledge assessment on child abuse with scoring on adequate knowledge (8-15) and inadequate knowledge (0-7). The reliability was done by Karl Pearson correlation co-efficient formula. The gathered data were analysed by frequency and percentage. Findings depicts the majority of mothers (48%) were in age group of 20-30 years, 46% of these mothers had primary level of education, most of them(62%) were farmers, 66% of these mothers were living in nuclear families and youngest child of 49% mothers was less than five years of age. 70% mothers had adequate knowledge.

Immature seeds of Boscia senegalensis (Anza in Hausa language) used in human nutrition, undergo several treatments to remove bitterness. This study is to analyse the influence of removing bitterness on the nutritional value of these seeds. Seeds from 14 treatment methods are levied century in two department: Banibangou (Tillaberi) and Bambeye (Tahoua region). For the 14 methods, the contents of macronutrients (Fats and proteins contents) (fats and proteinaceous material), micronutrients (P, B, K, Ca, Mg, Mn, Cu, Zn, Fe and Na), in phytic acid as well as antioxidant activity are determined. At the macronutrient level the seeds are rich in proteins (16.11 to 22.8%). Analysis of the results shows a significant decrease in mineral content and a significant increase in protein levels s. After ash fractionation, a significant decrease in the content of P, K, Ca, Mg, Mn, Cu and B is observed for all these methods. On the other hand, the Na content shows a significant increase. The methods used in Banibangou don’t show significant increase in ORAC and GAE with the exception of the G3 method and those of Bambèye, all showed a significant decrease. It can be seen that the different treatment methods significantly reduce micronutrient levels. However, Boscia seeds are a source of protein and some minerals (Fe, Zn, Ca), better than some cereals (millet, maize) and cowpea, for populations.

Background: Neck pain is a common musculoskeletal complaint with tremendous impact on health and quality of life. Neck pain also leads to pulmonary function restrictive disorder. Aim: This study aimed to investigate the effect of deep cervical muscle training using pressure biofeedback device on ventilatory functions in patients with chronic mechanical neck pain. Subjects: Forty subjects of both sexes with mean age 24.8± 1.87 years were participated in this study. They were divided into two groups equal in number; the study group (A) and the control group (B) who were suffering from chronic mechanical neck pain. Methods: Group A received deep cervical flexor strengthening exercises and traditional physical therapy modalities. Group B received only traditional physical therapy modalities. Both groups were assessed using the neck disability index questionnaire for functional disability, visual analogue scale for pain intensity, craniocervical flexion test for deep cervical flexor muscle strength and spirometric tests for ventilatory functions. Patients were assessed before and after treatment. Results: The results of this study showed that there was significant improvement in craniocervical flexion test, maximum voluntary ventilation and peak expiratory flow rate in the study group only (p = 0.0001). There was a statistically significant improvement in neck disability index (p = 0.0001), visual analogue scale (p= 0.0001), forced vital capacity (p = 0.002) and forced expiratory volume in 1 second (p= 0.01) in both groups, however, there was no statistically significant difference between both groups. Conclusion: It is concluded that deep cervical flexor strengthening exercise combined with traditional physical therapy modalities have better clinical effects on the mechanical neck pain and ventilatory functions than traditional physical therapy modalities alone in patients with chronic mechanical neck pain.

Explosion-proof diesel engine has a strong adaptability to harsh environment, but also has strict requirements for oil injection characteristics. According to the theory of hydrodynamics, a physical model was built to test the capture rate under different spacing between nozzle hole and oil inlet. The relationship between injection temperature and pressure in injection chamber and injection characteristics of nozzle was obtained. When the second-order effect of piston reciprocating motion is neglected, the diffusive angle of the nozzle holes with vertical structure is smaller under the experimental parameters. It can be seen that the size of injection cross-section has little effect on the capture rate, and the reflux characteristic of the oil chamber is the key factor affecting the capture rate.

We present the case of a 68-year-old female patient, radio fracture in february 2018, for which she was hospitalized for a closed reduction with immobilization for 3 weeks. Patient referred Rehabilitation, with pain that began the day 2 weeks after removal of plaster for Colles fracture, the pain is oppressive on the back and palm of right hand, of intensity 8/10, presents allodynia, electrical discharges from fingers to forearm, constant tingling, denies burning, the pain intensifies to 10/10 intensity. The right upper extremity intact, hyprotrophy is observed in the forearm, back and palm of the hand, which is with erythema, smooth skin, with loss of hair in forearm compared to contralateral side, mobility arcs limited by pain, strength and reflexes are not explored, patient does not allow to evaluate, allodynia in C6, C7, C8, distal predominance (forearm and hand), good capillary refill. We diagnose complex regional type II pain syndrome and start treatment with tramadol. One week later he went to a brachial plexus block via the axillary with pain 8/10, blockade was performed with lidocaine 1% 60mg + Dexamethasone 8mg without complications. Go to review a day later with good response, pain 5/10, continue with tramadol. the blockade was made 2 more times each week, with a gradual decrease in intensity of pain 2/10 of burning type that is exacerbated when carrying out daily activities. Complex regional pain syndrome (CRPS) was defined in 1993 by the International Association for the Study of Pain (IASP) as one:"Variety of painful conditions of regional localization, after a lesion, presenting a distal predominance of abnormal symptoms, exceeding in magnitude and duration the expected clinical course of the initial incident, frequently causing significant motor deterioration, with a variable progression over time. " The diagnosis It is done by applying Budapest criteria by the IASP. The treatment are several therapeutic approaches among which we find medical and pharmacological treatment, psychological treatment, occupational therapy, rehabilitation treatment and more recently the treatment with spinal electrical stimulation. Although the therapeutic approach of CRPS requires a multidisciplinary approach, the most important thing is that the treatment be early, individual, progressive and painless.

This study examined contemporary urban environmental management crises with focus on increasing rates of domestic sewage generation in Port Harcourt. It adopted the use of cross – sectional research design where both primary and secondary data were used. The primary data were generated through the use of field observations, oral interviews and 5005 copies of questionnaire administered in ten stratified randomly selected areas. Ten research assistants were used for data collection in each zone. Six research questions and six specific objectives guided the study. The data was analyzed using descriptive statistics. Findings revealed high rate of sewage generation in the city which is spatially defined in line with population densities of the various segments of the city. Three principal sites are used for indiscriminate sewage disposal activities– mostly into creeks at Iwofe (Mini-kpiti)–Rumuolumeni; Amadi-Ama Creek; and into burrow-pits at Igbo– Etche area. The indiscriminate disposal of sewage in the urban environment is causing serious social and environmental challenges such as pollution of water resources, soil and food crops; environmental foul odours and eye-scores; spread of pathogens which cause sicknesses and sudden deaths. The authors concluded by recommending proper treatment of sewage before evacuation, enactment and implementation of good laws, immediate closure of all illegal dump sites and designation of well supervised and coordinated disposal sites.

A Demoness as the central component of the festival and its celebration. This festival is connected with the story of a Demoness Ḍhaunḍhā and her destruction by the fire during in the Phālgunotsava which falls on the full Moon day at the end of Phālguna. The festival is celebrated on the last day of Phālguna at Pourṇami in all villages and cities. Phālgunotsava celebrating for destroying a Demoness named Ḍhaunḍhā. A variety of description of the Vasantotsava record the adventured of this Demoness under the name Holākā and detail her destruction at this time. The festival is believed related to ashes of Holākā fire is destroy all threat from the evil.

IFIs are ‘presence of fungal elements either as molds or yeast in deep tissue biopsy or needle aspirates that is confirmed on culture and histopathological examination. Invasive fungal infections (IFI) have significantly increased due to advances in medical care in the ‘at risk’ immune compromised population. Diagnosis of IFIs is extremely challenging, because current diagnostic methods are not sufficiently sensitive or specific and results are often available too late to be clinically useful. Here we report a case of Invasive Mucormycosis, successfully managed using multidisciplinary approach. Three months old male child, presented with persisting fever unresponsive to ususal line of management. Child was severely malnourished with bilateral pneumonia with right sided hemiparesis and convulsions. Baby had excoriated skin lesions around nasal alae, shrunken left eye, large palatal perforation, oral thrush, nasal crusting. MRI brain showed large left parietal lobe abscess. Ophthalmological examination revealed left eye exposure keratitis with optic atrophy and old central retinal artery occlusion (CRAO). Child was given antifungal in the form of Liposomal Amphotericin B in addition to Antibiotics, IV fluids and Anticonvulsants. Brain abscess was drained and palatal perforation was debrided. Pus culture from nasal tissue grew aseptate filamentous fungal elements of Mucor. Lymphocyte subset assay suggested subnormal CD 19, CD3/CD4 and NK cell levels. Child responded well to Liposomal amphotericin B. On discharge child was vitally stable, had gained weight, healed skin lesions with no respiratory complaints. Was advised physiotherapy for residual paralysis and plastic surgery for residual palatal perforation. Malnutrition in the child, altered immunological status of the child, relatively nonspecific, multi systemic symptoms and relatively limited sensitivity and specificity of diganostic tests proved challenging in the management of this case.

Myelomeningocele is a neural tube defect characterized by a cleft in the vertebral column with a corresponding defect in the overlying skin leading to protrusion of the meninges and spinal cord through the defect. Myelomeningocele is the most common congential malformation of the central nervous system. The incidence of myelomeningocele has decreased all over the world significantly in the last decade. However the incidence is much higher in India and other developing countries. The present study aims at finding the incidence of myelomeningocele in northwestern Rajasthan and to evaluate the outcome of myelomeningocele after surgery. The study was conducted at Medical College Hospital, Bikaner.

Acute pulmonary negative pressure edema (NPPE) also known as post-obstructive pulmonary edema is a life-threatening clinical scenario in which pulmonary edema develops immediately after upper airway obstruction. A review of the literature suggests that in healthy adults undergoing general anesthesia the incidence of NPPE is estimated at 0.05% to 0.1% .4,5. The pathophysiology of post obstructive pulmonary edema is multifactorial, with components of pulmonary edema of negative pressure, hypoxia and hyperadrenergic state. Hypoxia and a hyperadrenergic state are other factors that contribute to the development of EPPN. Hypoxia can increase pulmonary vascular resistance and pulmonary capillary pressure. It can also alter capillary integrity and precipitate a hyperadrenergic state. It is believed that a hyperadrenergic response redistributes blood from the systemic veins to the pulmonary circuit and increases pulmonary vascular resistance. All these events can promote the formation of edema. Finally, hypoxia and acidosis can depress myocardial performance and aggravate pulmonary edema.2In the clinical presentation, initial findings usually include decreased oxygen saturation, with foamy pink foam and abnormalities on the chest x-ray.20 Manifestations of acute airway obstruction include stridor, supraslary and supraclavicular retractions, urgent use of accessory muscles of inspiration and panic in facial expression. As NPPE develops, auscultation usually reveals crackles and occasional wheezing. Pulmonary edema causes both impaired oxygen diffusion and lack of ventilation / perfusion matching, leading to sudden and possibly severe hypoxemia. The typical chest radiograph will show diffuse interstitial and alveolar infiltrates. Treatment strategies vary according to the severity of the symptoms of POPE but are similar for type I treatment and type II. Support measures include the maintenance of a patent. Airway and ensuring adequate oxygenation through supplements. Oxygen with the addition of positive end expiratory pressure (PEEP) or continuous positive airway pressure guided by physical examination, pulse oximetry and arterial blood gases determinations.