Predictive and diagnostic measures for kernicterus spectrum disorder: a prospective cohort study.

BACKGROUND: Kernicterus spectrum disorder (KSD) resulting from neonatal hyperbilirubinemia remains a common cause of cerebral palsy worldwide. This 12-month prospective cohort study followed neonates with hyperbilirubinemia to determine which clinical measures best predict KSD. METHODS: The study enrolled neonates ≥35 weeks gestation with total serum bilirubin (TSB) ≥ 20 mg/dl admitted to Aminu Kano Hospital, Nigeria. Clinical measures included brain MRI, TSB, modified bilirubin-induced neurologic dysfunction (BIND-M), Barry-Albright Dystonia scale (BAD), auditory brainstem response (ABR), and the modified KSD toolkit. MRI signal alteration of the globus pallidus was scored using the Hyperbilirubinemia Imaging Rating Tool (HIRT). RESULTS: Of 25 neonates enrolled, 13/25 completed 12-month follow-up and six developed KSD. Neonatal BIND-M ≥ 3 was 100% sensitive and 83% specific for KSD. Neonatal ABR was 83% specific and sensitive for KSD. Neonatal HIRT score of 2 was 67% sensitive and 75% specific for KSD; this increased to 100% specificity and sensitivity at 12 months. BAD ≥ 2 was 100% specific for KSD at 3-12 months, with 50-100% sensitivity. CONCLUSIONS: Neonatal MRIs do not reliably predict KSD. BIND-M is an excellent screening tool for KSD, while the BAD or HIRT score at 3 or 12 months can confirm KSD, allowing for early diagnosis and intervention. IMPACT: The first prospective study of children with acute bilirubin encephalopathy evaluating brain MRI findings over the first year of life. Neonatal MRI is not a reliable predictor of kernicterus spectrum disorders (KSD). Brain MRI at 3 or 12 months can confirm KSD. The modified BIND scale obtained at admission for neonatal hyperbilirubinemia is a valuable screening tool to assess risk for developing KSD. The Barry Albright Dystonia scale and brain MRI can be used to establish a diagnosis of KSD in at-risk infants as early as 3 months.

Medullary brainstem gliomas in an adult: A rare case report and challenging tumor.

Background: Medullary brainstem lesions are rare tumors that are challenging to treat due to their location in the brainstem, which controls vital functions such as breathing, heart rate, and blood pressure. While the most common subtype is the aggressive diffuse intrinsic pontine glioma, other subtypes exist, including focal brainstem gliomas and cervicomedullary gliomas. The prognosis for patients with brainstem gliomas is generally poor, and treatment options are limited. Early detection and treatment are crucial to improve outcomes for patients with these tumors. Case Description: In this case report, the authors describe a 28-year-old male from Saudi Arabia who presented with headaches and vomiting. Imaging studies and clinical examination revealed a high-grade astrocytoma medullary brainstem lesion. The patient underwent radiation therapy and chemotherapy, effectively controlling tumor growth and improving his quality of life. However, a residual tumor remained, and the patient underwent neurosurgery to resect the remaining tumor was successful in removing the tumor, and the patient showed significant improvement in his symptoms and overall health. Conclusion: This case highlights the importance of early detection and treatment of medullary brainstem lesions. While radiation therapy and chemotherapy are primary treatment options, neurosurgery may be necessary to resect residual tumors. In addition, cultural and social factors may need to be considered in managing these tumors in Saudi Arabia.

Effects of spinal manipulation or mobilization as an adjunct to neurodynamic mobilization for lumbar disc herniation with radiculopathy: a randomized clinical trial.

OBJECTIVES: To determine the long-term clinical effects of spinal manipulative therapy (SMT) or mobilization (MOB) as an adjunct to neurodynamic mobilization (NM) in the management of individuals with Lumbar Disc Herniation with Radiculopathy (DHR). DESIGN: Parallel group, single-blind randomized clinical trial. SETTING: The study was conducted in a governmental tertiary hospital. PARTICIPANTS: Forty (40) participants diagnosed as having a chronic DHR (≥3 months) were randomly allocated into two groups with 20 participants each in the SMT and MOB groups. INTERVENTIONS: Participants in the SMT group received high-velocity, low-amplitude manipulation, while those in the MOB group received Mulligans' spinal mobilization with leg movement. Each treatment group also received NM as a co-intervention, administered immediately after the SMT and MOB treatment sessions. Each group received treatment twice a week for 12 weeks. OUTCOME MEASURES: The following outcomes were measured at baseline, 6, 12, 26, and 52 weeks post-randomization; back pain, leg pain, activity limitation, sciatica bothersomeness, sciatica frequency, functional mobility, quality of life, and global effect. The primary outcomes were pain and activity limitation at 12 weeks post-randomization. RESULTS: The results indicate that the MOB group improved significantly better than the SMT group in all outcomes (p < 0.05), and at all timelines (6, 12, 26, and 52 weeks post-randomization), except for sensory deficit at 52 weeks, and reflex and motor deficits at 12 and 52 weeks. These improvements were also clinically meaningful for neurodynamic testing and sensory deficits at 12 weeks, back pain intensity at 6 weeks, and for activity limitation, functional mobility, and quality of life outcomes at 6, 12, 26, and 52 weeks of follow-ups. The risk of being improved at 12 weeks post-randomization was 40% lower (RR = 0.6, CI = 0.4 to 0.9, p = 0.007) in the SMT group compared to the MOB group. CONCLUSION: This study found that individuals with DHR demonstrated better improvements when treated with MOB plus NM than when treated with SMT plus NM. These improvements were also clinically meaningful for activity limitation, functional mobility, and quality of life outcomes at long-term follow-up. TRIAL REGISTRATION: Pan-African Clinical Trial Registry: PACTR201812840142310.

Eclampsia a preventable tragedy: an African overview.

Eclampsia is a multisystemic disease associated with various complications which individually or in combination can lead to maternal/fetal morbidity and mortality. Developed countries and some developing countries were largely successful in reducing the incidence of eclampsia. Developing countries especially those in Sub-Saharan Africa (SSA) are still dealing with high incidence of eclampsia. The question is why have the incidence and mortality of eclampsia remained high in SSA? The risk factors for this disease are globally the same but a critical assessment showed that there are certain risk factors that are common in Sub-Saharan Africa (multiple pregnancy, sickle cell disease, pregnancies at the extremes of reproductive age, pre-existing vasculitis). In addition, there are compounding factors (illiteracy, poverty, superstitious beliefs, poor prenatal care services, poorly trained manpower and lack of facilities to cater for patients). Addressing the menace of this disease require a holistic approach which among others, includes education to address beliefs and reduce harmful practices, poverty alleviation which will improve the ability for communities to afford health care services. Improving transport services to convey patients quickly to facilities on time when there is need. Improving the health infrastructure, building more facilities, providing trained and motivated manpower and regular supply of quality essential drugs for the management of the disease. This review is meant to analyze factors prevalent in Sub-Saharan that hinder reducing incidence of the disease and provide comprehensive and cost-effective solutions.

Facility and care provider emergency preparedness for neonatal resuscitation in Kano, Nigeria.

INTRODUCTION: The knowledge, attitude, and practice of emergency neonatal resuscitation are critical requirements in any facility that offers obstetric and neonatal services. This study aims to conduct a needs assessment survey and obtain individual and facility-level data on expertise and readiness for neonatal resuscitation. We hypothesize that neonatal emergency preparedness among healthcare providers in Kano, Nigeria is associated with the level of knowledge, attitudinal disposition, practice and equipment availability at the facility level. METHODS: A semi-structured, self-administered questionnaire was administered to a cross-section of health providers directly involved with neonatal care (n = 112) and attending a neonatal resuscitation workshop in Kano state. Information regarding knowledge, attitude, practice and facility preparedness for neonatal resuscitation was obtained. Bloom's cut-off score and a validated basic emergency obstetric and neonatal care assessment tool were adopted to categorize outcomes. Multivariable logistic regression was employed to determine independent predictors of knowledge and practice. RESULTS: Almost half (48% and 42% respectively) of the respondents reported average level of self-assessed knowledge and comfort during resuscitation. Only 7% (95% CI:3.2-13.7) and 5% (95% CI:2.0-11.4) of health providers demonstrated good knowledge and practice scores respectively, with an overall facility preparedness of 46%. Respondents' profession as a physician compared to nurses and midwives predicted good knowledge (aOR = 0.08, 95% CI: 0.01-0.69; p = 0.01), but not practice. CONCLUSION: Healthcare provider's knowledge and practice including facility preparedness for emergency neonatal resuscitation were suboptimal, despite the respondents' relatively high self-assessed attitudinal perception. Physicians demonstrated higher knowledge compared to other health professionals. The low level of respondents' awareness, practice, and facility readiness suggest the current weak state of secondary health systems in Kano.

Knowledge and current practices of Nigerian physiotherapists on the physical activity and exercise training in the rehabilitation of patients with asthma.

OBJECTIVES: The study aimed to determine the knowledge and current practices of Nigerian physiotherapists on the physical activity and exercise training in the rehabilitation of patients with asthma and to determine if any difference exists between novice and expert professionals. METHODS: This was designed as a cross-sectional study. A total of 311 practicing physiotherapists in Nigeria participated in the study. An electronic questionnaire comprising 34 semi-structured questions with three domains; personal information, knowledge, and current practices, was used to collect data throughout 4-months. Data were analyzed using a pragmatist paradigm. RESULTS: Out of the physiotherapists, 51.8% (n = 161) had postgraduate degrees, 46.9% (n = 146) had bachelor's degrees, and 1.3% (n = 4) had a doctor of physiotherapy degrees. The result also indicates that 45.3% (n = 141) of the physiotherapists had insufficient knowledge about asthma, and 39.5% (n = 123) were not using current clinical practice in the rehabilitation of patients with asthma. The results also indicate that expert physiotherapist has more knowledge and also uses current practices when compared to novice physiotherapist. CONCLUSIONS: Even though expert physiotherapists have better knowledge and current practices when compared to the novice physiotherapists, the overall outcomes indicate that Nigerian physiotherapists had insufficient knowledge about asthma and were not using current clinical practice in the rehabilitation of patients with asthma.

Effect of transcranial direct current stimulation (tDCS) delivered via dorsolateral prefrontal cortex on central post-stroke pain and depression: a case report.

BACKGROUND: Transcranial direct current stimulation (tDCS) is effective in the management of patients with central post-stroke pain (CPSP) and post-stroke depression (PSD) individually. However, it is not known if tDCS delivered via dorsolateral prefrontal cortex (DLPFC) can be used to ameliorate both symptoms. OBJECTIVE: The purpose of this case report was to share the effectiveness of using tDCS of the DLPFC with short inter-session intervals to reduce central pain and depression in a stroke survivor. CASE DESCRIPTION: A 45-year-old patient presented with CPSP and depression following a stroke. The CPSP and depression were diagnosed using the Douleur Neuropathique 4 Questionnaire (DN4Q) and the Beck Depression Index (BDI) respectively. The pain score was 10 on a visual analogue scale (VAS) and it was a hemi-body burning sensation, with a score of 7 on DN4Q, and the depression score was 25 on the BDI. The patient received anodal tDCS to the left DLPFC using two different application protocols. Initially, a stimulation session of 2 milliamperes (mA) intensity for 20 minutes was given every working day for 2 weeks. After 3 weeks, she then received 7 daily sessions of periodic stimulations of 2 mA intensity for 13 minutes each with 20 minutes inter-session intervals for 1 week. The patient was followed up for 6 months post-intervention. OUTCOMES: Immediately following the last session of the initial protocol of stimulation, the BDI score reduced from 25 to 7 and the pain became abolished. However, the symptoms relapsed at 3 weeks post-intervention to the initial BDI score of 25, VAS score of 10 and DN4Q score of 7. Following the application of the second protocol of stimulation, the BDI score improved to 18 at three weeks and later to 7 at six months post-intervention while the pain (both VAS and DN4Q) became completely abolished. CONCLUSIONS: Further research is needed to determine if a series of periodic tDCS with short-intersession intervals applied to the DLPFC may be more effective than a single tDCS with long inter-session intervals, in decreasing pain and inducing long-term improvement in mood in people with stroke.

Mediastinal parathyroid adenoma removal by video-assisted thoracoscopic surgery.

Ectopic parathyroid adenomas in the mediastinum are rare causes of primary hyperparathyroidism. We report two cases of mediastinal parathyroid adenoma. Functioning parathyroid lesion was localized with the help of nuclear single-photon emission computed tomography scan in both the patients. Video assisted thoracoscopic surgical (VATS) removal of the parathyroid lesions were done. Intraoperative confirmation of parathyroid adenoma was done by frozen section. Further confirmation was done by routine histopathological examination of specimen postoperatively. One patient had left vocal cord paralysis postoperatively. Localization by functional imaging is essential. Minimally invasive methods such as VATS are useful in removing mediastinal parathyroid hyperfunctioning lesions, which carries early postoperative recovery and less complications.

Résumé Les adénomes parathyroïdes ectopiques dans le mediastinum sont des causes rares de l'hyperparathyroïdie primaire. Nous rapportons deux cas d'adénome parathyroïde mediastinal. La lésion parathyroïde de fonctionnement a été localisée avec l'aide du balayage nucléaire de SPECT dans les deux patients. L'enlèvement thoracoscopic aidé vidéo de chirurgie (VATS) des lésions parathyroïdes ont été faits. La confirmation intraopératoire de l'adénome parathyroïde a été faite par section gelée. Une confirmation supplémentaire a été faite par l'examen histopathologique courant du spécimen post opératoirement. Un patient avait laissé la paralysie de corde vocale postopératoirement. La localisation par imagerie fonctionnelle est essentielle. Les méthodes mini-invasives telles que le VATS sont utiles pour enlever les lésions de fonctionnement hyper-médiantinal, qui portent le rétablissement postopératoire tôt et moins de complications.

Constraint-induced movement therapy protocols using the number of repetitions of task practice: a systematic review of feasibility and effects.

BACKGROUND: High repetitions of task practice is required for the recovery of the motor function during constraint-induced movement therapy (CIMT). This can be achieved into ways: when the task practice is measured in hours of practice or when the number of repetitions is counted. However, it has been argued that using hours of task practice as a measure of practice does not provide a clear instruction on the dose of practice. AIM: The aim of this study is to determine the feasibility and effects of the CIMT protocol that uses the number of repetitions of task practice. MATERIALS/METHOD: The study was a systematic review registered in PROSPERO (CRD42020142140). Five databases, PubMED, CENTRAL, PEDro, OTSeeker and Web of Science, were searched. Studies of any designs in adults with stroke were included if they used the number of repetitions of task practice as a measure of dose. The methodological quality of the included studies was assessed using Modified McMaster critical review form. The results were analysed using qualitative synthesis. RESULTS: Eight studies (n = 205) were included in the study. The number of task repetitions in the studies ranges between 45 and 1280 per day. The results showed that CIMT protocol using the number of repetitions of task practice was feasible and improved outcomes such as motor function, quality of life, functional mobility and spasticity. CONCLUSION: The number of repetitions of task practice as a measure of CIMT dose can be used in place of the existing protocol that uses the number of hours of task practice.

Synthesis of Nano-Magnetite from Industrial Mill Chips for the Application of Boron Removal: Characterization and Adsorption Efficacy.

The present study synthesized nano-magnetite (Fe3O4) from milled steel chips using the high energy ball milling (HEBM) method, characterized it, and then utilized it as a sorbent to remediate boron concentration at various pH (4-9), dosages (0.1-0.5 g), contact times (20-240 min), and initial concentrations (10-100 mg/L). The nano-sorbents were characterized based on SEM structure, elemental composition (EDX), surface area analysis (BET), crystallinity (XRD), and functional group analysis (FTIR). The highest adsorption capacity of 8.44 mg/g with removal efficiency of 84% was attained at pH 8, 0.5 g dosage, contact time of 180 min, and 50 mg/L initial concentration. The experimental data fit best with the pseudo-second-order kinetic model with R2 of 0.998, while the Freundlich adsorption isotherm describes the adsorption process with an R2 value of 0.9464. A regeneration efficiency of 47% was attained even after five cycles of reusability studies. This efficiency implies that the nano-magnetite has the potential for sustainable industrial application.

A Comparison Between the Effect of Combined Chain Exercises Plus Kinesio Taping With Combined Chain Exercises Alone in Knee Osteoarthritis: A Randomized Clinical Trial.

OBJECTIVE: This study aimed to examine the effect of Kinesio taping as an adjunct to combined chain exercises compared with combined chain exercises alone in the management of individuals with knee osteoarthritis. METHODS: A total of 60 (27 male, 33 female) individuals (age range = 50-71 yrs and mean age = 54.26 ± 8.83 yrs) diagnosed as having mild to moderate knee osteoarthritis (based on the Kellgren and Lawrence grade I-III classification) were randomly allocated into two groups with 30 participants each in the Kinesio taping + combined chain exercises and combined chain exercises groups. Participants in the Kinesio taping + combined chain exercises group received Kinesio taping plus combined chain exercises and those in the combined chain exercises group received only combined chain exercises. Each participant was assessed for pain, range of motion, functional mobility, and quality of life at baseline and after 8 wks of intervention. A mixed-design multivariate analysis of variance was used to analyze the treatment effect. RESULTS: No significant differences were observed in the baseline characteristics of participants in both groups. The result indicated that there was a significant time effect for all outcomes, with a significant interaction between time and intervention (P < 0.001). The Bonferroni post hoc analyses of time and intervention effects indicated that the Kinesio taping + combined chain exercises group improved significantly better than the combined chain exercises group in all outcomes, pain (mean = 2.01 [0.64] vs. 3.94 [1.12], F[df] = 5.466[1,58], P = 0.011), flexion range of motion (mean = 121.15 [2.07] vs. 104.28 [3.24], F[df] = 26.722[1,58], P < 0.001), functional mobility (mean = 19.47 [1.95] vs. 31.01 [2.39], F[df] = 29.436[1,58], P < 0.001), and quality of life (mean = 68.76 [3.19] vs. 45.62 [2.87], F[df] = 71.984[1,58], P < 0.001), after 8 wks of intervention. CONCLUSIONS: The findings of this study concluded that Kinesio taping + combined chain exercises and combined chain exercises were both effective but Kinesio taping plus combined chain exercises was more effective in the management of individuals with knee osteoarthritis. TRIAL REGISTRATION: Pan African Clinical Trial Registry: PACTR201810603949411.

Utilization of Nano-TiO2 as an Influential Additive for Complementing Separation Performance of a Hybrid PVDF-PVP Hollow Fiber: Boron Removal from Leachate.

The continuous increase in anthropogenic activities resulting in an increase in boron concentration in the environment is becoming a serious threat to public health and the ecosystem. In this regard, a hybrid polyvinylidene fluoride (PVDF)-polyvinyl pyrrolidone (PVP) hollow fiber was synthesized with hydrophilic nano-titanium oxide (TiO2) at varied loadings of 0, 0.5, 1.0, 1.5, and 2.0 wt% using the phase inversion technique. The resultant membranes were characterized in terms of Scanning Electron Microscopy (SEM), Energy Dispersive X-ray Spectroscopy (EDX), contact angle, porosity, and zeta potential. The permeability flux was assessed using both pure water and leachate; also, rejection performance was evaluated based on boron removal from the leachate. The results revealed that the membrane with 1.0 wt% loading had the highest flux alongside an upturn in boron rejection percentage of 223 L/m2·h and 94.39%, respectively. In addition, the lowest contact angle of 50.01° was recorded with 1.0 wt% TiO2 loading, and this implies that it is the most hydrophilic. Throughout the experiment cycles, the fiber with 1.0 wt% TiO2 loading demonstrated a high flux recovery varying between 92.82% and 76.26% after 9 h filtration time. The physicochemical analysis of the permeate revealed that the boron concentration was significantly reduced to 0.43 mg/L, which is far lower than the discharge limit of 1.0 mg/L.

Decolorization of Palm Oil Mill Effluent by Klebsiella Pneumonia ABZ11: Remediation Efficacy and Statistical Optimization of Treatment Conditions.

Colorants contained in palm oil mill effluent (POME) are recalcitrant and carcinogenic in nature. The commonly applied ponding treatment methods have been reported inefficient for remediating the concentration of the colorants before discharge. The need for sustainable and efficient treatment technique is crucial in order to preserve the environment. In this view, this study reported the first attempt to decolorize POME using a proliferate Klebsiella Pneumonia ABZ11 at varied inoculum sizes of 5-25% (v/v), initial color concentration (650-2,600 ADMI) and treatment time of 5-40 h. The treatment conditions were optimized using Response Surface Methodology. At optimal conditions of 20% (v/v) inoculum size, initial-color concentration of 2,600 ADMI, initial pH of 7 and 35 h treatment retention time, over 80.40% color removal was achieved with insignificant disparity compared with the model predicted value of 81.538%. Also, the Monod model excellently described the decolorization kinetic process with 0.9214 coefficient of correlation (R 2), and the calculated maximum growth µ max ) and half-saturation constant (K s ) were 7.023 d-1 and 340.569 ADMI d-1, respectively. This study revealed that the Klebsiella Pneumonia ABZ11 was highly prolific and such feature may favor a synergistic biodegradation process.

Does exercise program of endurance and strength improve health-related quality of life in persons living with HIV-related distal symmetrical polyneuropathy? A randomized controlled trial.

BACKGROUND: The most common HIV neurological comorbidity, Distal Symmetrical Peripheral Neuropathy (DSPN), is characterized by severe symptoms and reduced quality of life. Exercise has consistently been mentioned as one of the non-pharmacological therapies for the rehabilitation of individuals with HIV, but little is known about an exercise program to recommend to people living with HIV (PLWHIV)-related DSPN. The purpose of this study was to investigate the effectiveness of aerobic (AE) or progressive resisted exercise (PRE) on quality of life (QOL) in a person living with HIV-related DSPN. METHOD: A randomized controlled trial was conducted with 136 persons living with HIV-related Neuropathy, including 6 domains of QOL within WHOQOL-BREF, 45 in the AE (used ergometer), 44 in the PRE (used quadriceps bench), and 47 in the control group (CG). The outcome measures (QOL) data were analyzed using the inferential statistic of Friedman for within-group with post hoc analysis of Wilcoxon signed Test. A Kruskal-Wallis test was carried out for between-groups with post hoc analysis of Mann-Whitney to find where significant differences exist. RESULTS: The results indicated significant differences within experimental groups in all six domains p < 0.05. Similarly, the result indicated significant differences within the CG in Physical, level of independence, and Spirituality/Religions domains (p = 0.002, p = 0.035, p = 0.006). However, the results indicated significant differences between experimental groups and CG. CONCLUSION: These findings indicated that strength and endurance exercise of moderate intensity have a positive effect on QOL in PLWHIV-related DSPN. Clinical trial No. http://apps.who.int/trialsearch/default.aspx (PACTR201707002173240).

Permeability and Antifouling Augmentation of a Hybrid PVDF-PEG Membrane Using Nano-Magnesium Oxide as a Powerful Mediator for POME Decolorization.

This study focused on developing a hydrophilic hybrid polyvinylidene fluoride (PVDF)-polyethylene glycol (PEG) hollow membrane by incorporating Nano-magnesium oxide (NMO) as a potent antifouling mediator. The Nano-hybrid hollow fibers with varied loading of NMO (0 g; 0.25 g; 0.50 g; 0.75 g and 1.25 g) were spun through phase inversion technique. The resultants Nano-hybrid fibers were characterized and compared based on SEM, EDX, contact angle, surface zeta-potential, permeability flux, fouling resistance and color rejection from palm oil mill effluent (POME). Noticeably, the permeability flux, fouling resistance and color rejection improved with the increase in NMO loading. PVDF-PEG with 0.50 g-NMO loading displayed an outstanding performance with 198.35 L/m2·h, 61.33 L/m2·h and 74.65% of water flux, POME flux and color rejection from POME, respectively. More so, a remarkable fouling resistance were obtained such that the flux recovery, reversible fouling percentage and irreversible fouling percentage remains relatively steady at 90.98%, 61.39% and 7.68%, respectively, even after 3 cycles of continuous filtrations for a total period of 9 h. However, at excess loading of 0.75 and 1.25 g-NMO, deterioration in the flux and fouling resistance was observed. This was due to the agglomeration of nanoparticles within the matrix structure at the excessive loading.

Knowledge and current practices of physiotherapists on the physical activity and exercise in the rehabilitation of children with epileptic seizures.

BACKGROUND: Physiotherapists play a key role in the rehabilitation of children with epileptic seizures. Regular physical exercise generates psychological and physiological benefits for people with epilepsy. DESIGN: This study was a cross-sectional design. PURPOSE: The purpose of this study was to evaluate the knowledge and current practices of physiotherapists on the physical activity and exercise in the rehabilitation of children with epileptic seizures in Nigeria. METHODS: Physiotherapists with minimum bachelor's degrees were invited to participate in the study using an electronic questionnaire. The subjects (N = 117) answered a questionnaire comprising 33 simple closed-ended questions with three domains: personal information, knowledge, and current practices. RESULTS: Out of the 117 physiotherapists, 77.7% (n = 91) had postgraduate degrees, 16.2% (n = 19) had bachelor's degree in physiotherapy, and only 5.9% (n = 7) had Doctor of Physical Therapy (DPT). The results also indicated that 79.5% (n = 93) of physiotherapists had sufficient knowledge about epilepsy, and 86.3% (n = 101) of physiotherapists were using current skills/physical activity to rehabilitate children with epileptic seizures. CONCLUSIONS: It was concluded that physiotherapists had sufficient knowledge about epilepsy and were using current skills/physical activity in the rehabilitation of children with epileptic seizures.

The Pertinence of Microwave Irradiated Coconut Shell Bio-Sorbent for Wastewater Decolourization: Structural Morphology and Adsorption Optimization Using the Response Surface Method (RSM).

Palm oil mill effluent contains carcinogenic coloured compounds that are difficult to separate due to their aromatic structure. Though colour treatment using adsorption processes at lower pH (<4) have been reported effectual, due to its acidity the remediated effluent poses an environmental hazard as a result. Thus, the current study focused on achieving decolourization at neutral pH by enhancing the morphology of the coconut shell activated carbon (CSAC) using N2 as activating-agent with microwave irradiation heating. The microwave pretreated and non-pretreated CSAC were characterized using scanned electron microscopy (SEM), energy dispersive X-ray (EDX) and Brunauer-Emmett-Teller (BET) analysis. A significant modification in the porous structure with a 66.62% increase in the specific surface area was achieved after the pretreatment. The adsorption experimental matrix was developed using the central composite design to investigate the colour adsorption performance under varied pH (6⁻7), dosage (2⁻6 g) and contact time (10⁻100 min). At optimum conditions of neutral pH (7), 3.208 g dosage and contact time of 35 min, the percentage of colour removal was 96.29% with negligible differences compared with the predicted value, 95.855%. The adsorption equilibrium capacity of 1430.1 ADMI × mL/g was attained at the initial colour concentration of 2025 ADMI at 27 °C. The experimental data fitted better with the Freundlich isotherm model with R² 0.9851.

Alfalfa (Medicago sativa L.) seed yield in relation to phosphorus fertilization and honeybee pollination.

This investigation was conducted at the Agricultural and Veterinary Training and Research Station, King Faisal University, Al-Ahsa, Saudi Arabia, during the alfalfa growing season in 2014. The study aimed to evaluate the impact of phosphorus fertilization and honeybee pollination on alfalfa seed production. The experiment was divided into 9 treatments of open pollination, honeybee pollination, and non-pollination with three different levels (0, 300 or 600 kg P2O5/ha/year) of triple super phosphate. All vegetative growth attributes of Hassawi alfalfa were significantly higher in the non-insect pollination plots, while the yield and yield component traits were significantly higher with either open pollination or honeybee pollination in parallel with the increasing level of phosphorus fertilizer up to 600 kg P2O5/ha/year in light salt-affected loamy sand soils. There was no seed yield in Hassawi alfalfa without insect pollination. Therefore, placing honeybee colonies near the fields of Hassawi alfalfa and adding 600 kg P2O5/ha/year can increase seed production.

A Case of Erythroderma Secondary to Hypereosinophilia.

Hypereosinophilic syndrome (HES) is a myeloproliferative disorder characterised by marked peripheral eosinophilia and end organ damage attributable to eosinophilia without secondary cause. Early recognition and treatment are essential to prevent morbidity and mortality. Cytoreduction with Steroids, Hydroxyurea and Imatinib are the main stay of treatment. Molecular studies like Fip1-like-1 fused with platelet derived growth factor receptor alpha (FIP1L1-PDGFRα) etc., are recommended in view of therapeutic implication. In this paper we report a rare case of HES developing in a lady 6 months after surgical removal of lymphangioma of spleen, which in itself is rare.

Cystic Pheochromocytoma Presenting as Adrenal Cyst.

Pheochromocytomas are usually solid tumours. But it can present as cystic lesions in the adrenal gland. Cystic lesions in adrenal gland with hypertension needs attention to rule out pheochromocytoma. If ignored, it may lead to hypertensive emergency, multisystem crisis and death. Early diagnosis with biochemistry, Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) of abdomen, proper functional imaging like Meta Iodo Benzyl Guanidine (MIBG) scan is essential. Proper preoperative preparation is important to prevent hypertensive crisis during and after surgery. We are reporting a case of cystic pheochromocytoma in a young male.