Proper Management
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2021 ◽  
Biniyam Sahiledengle ◽  
Daniel Atlaw ◽  
Abera Kumie ◽  
Yohannes Tekalegn ◽  
Demelash Woldeyohannes ◽  

Abstract Background: Adolescent girls face several challenges relating to menstruation and its proper management. Lack of adequate sanitary products, inadequate water supply, and privacy for changing sanitary pads continue to leave adolescent girls with limited options for safe and proper menstrual hygiene in many low-income settings, including Ethiopia. These situations are also compounded by societal myths, stigmas surrounding menstruation, and discriminatory social norms. This systematic review and meta-analysis aimed to estimate the pooled proportion of safe menstrual hygiene management among adolescent girls in Ethiopia using the available studies. Methods: We searched PubMed, Google Scholar, African Journal Online (AJOL), Hinari, Science Direct, ProQuest, Direct of Open Access Journals, POPLINE, and Cochrane Library database inception to May 31, 2021. Studies reporting the proportion of menstrual hygiene management among adolescent girls in Ethiopia were considered. The Cochrane Q test statistics and I2 tests were used to assess the heterogeneity of the included studies. Since the included studies revealed considerable heterogeneity, a random effect meta-analysis model was used to estimate the pooled proportion of safe MHM. Results: Of 1,045 identified articles, 22 studies were eligible for analysis (n=12,330 participants). The overall pooled proportion (PP) of safe MHM in Ethiopia was 52.69% (95%CI: 44.16, 61.22). The use of commercial menstrual absorbents was common 64.63% (95%CI: 55.32, 73.93, I2 99.2%) followed by homemade cloth 53.03% (95%CI: 22.29,83.77, I2 99.2%). Disposal of absorbent material into the latrine was the most common practice in Ethiopia 62.18% (95%CI:52.87,71.49, I298.7%). One in four girls reported missing one or more school days during menstruation (PP: 32.03%, 95%CI: 22.65%, 41.40%, I2 98.2%). Conclusion: This study revealed that only half of the adolescent girls in Ethiopia had safe MHM practices. To ensure that girls in Ethiopia can manage menstruation hygienically and with dignity, strong gender-specific water, sanitation, and hygiene (WASH) facilities along with strong awareness creation activities at every level are needed.

Shyamanta Das ◽  
Soumitra Ghosh ◽  
Dhrubajyoti Bhuyan ◽  
Hiranya Saikia ◽  
Hiranya Kumar Goswami ◽  

Background: There is overlap of symptoms in psychiatric disorders, especially in mental and behavioural disorders of childhood and adolescence. Half of all lifetime psychiatric disorders tend to arise by age 14 years and three fourths of them arise by age 24 years. Aim: To study the various types of mental and behavioural disorders of childhood and adolescence, and to find out comorbidities within and across the types. Methods: An observational cross-sectional study was carried out over a period of one year in the psychiatry department of a tertiary care general hospital. The psychiatric diagnoses according to the World Health Organization’s (WHO) tenth revision of the International Statistical Classification of Health and Related Problems (ICD-10) were categorised into type 1 (depression, anxiety, obsessive-compulsive disorder, and somatoform disorder), type 2 (attention-deficit/hyperactivity disorder, oppositional defiant disorder, and conduct disorder), type 3 (mental retardation, developmental disorders of speech and language, and scholastic skills, and pervasive developmental disorders). Descriptive statistics was used with frequency and percentage. Results: Total sample size was 137. Children and adolescents were almost equally distributed. Boys were more than girls. Type 3 disorders were maximum. Adolescents had mostly type 1 disorders. Children had mostly type 3 disorders. Girls had almost same number of type 1 and type 3 disorders. Boys had mostly type 3 disorders. Within group comorbidity was mostly with type 3 disorders. Across group comorbidity was highest in type2-type 3 disorders. Conclusion: Mental and behavioural disorders in childhood and adolescence do vary according to age and sex, and their recognition will help in the early diagnosis and proper management.

2021 ◽  
Vol 13 (15) ◽  
pp. 2879
Lida Andalibi ◽  
Ardavan Ghorbani ◽  
Mehdi Moameri ◽  
Zeinab Hazbavi ◽  
Arne Nothdurft ◽  

The leaf area index (LAI) is an important vegetation biophysical index that provides broad information on the dynamic behavior of an ecosystem’s productivity and related climate, topography, and edaphic impacts. The spatiotemporal changes of LAI were assessed throughout Ardabil Province—a host of relevant plant communities within the critical ecoregion of a semi-arid climate. In a comparative study, novel data from Google Earth Engine (GEE) was tested against traditional ENVI measures to provide LAI estimations. Moreover, it is of important practical significance for institutional networks to quantitatively and accurately estimate LAI, at large areas in a short time, and using appropriate baseline vegetation indices. Therefore, LAI was characterized for ecoregions of Ardabil Province using remote sensing indices extracted from Landsat 8 Operational Land Imager (OLI), including the Enhanced Vegetation Index calculated in GEE (EVIG) and ENVI5.3 software (EVIE), as well as the Normalized Difference Vegetation Index estimated in ENVI5.3 software (NDVIE). Moreover, a new field measurement method, i.e., the LaiPen LP 100 portable device (LP 100), was used to evaluate the accuracy of the derived indices. Accordingly, the LAI was measured in June and July 2020, in 822 ground points distributed in 16 different ecoregions-sub ecoregions having various plant functional types (PFTs) of the shrub, bush, and tree. The analyses revealed heterogeneous spatial and temporal variability in vegetation indices and LAIs within and between ecoregions. The mean (standard deviation) value of EVIG, EVIE, and NDVIE at a province scale yielded 1.1 (0.41), 2.20 (0.78), and 3.00 (1.01), respectively in June, and 0.67 (0.37), 0.80 (0.63), and 1.88 (1.23), respectively, in July. The highest mean values of EVIG-LAI, EVIE-LAI, and NDVIE-LAI in June are found in Meshginshahr (1.40), Meshginshahr (2.80), and Hir (4.33) ecoregions and in July are found in Andabil ecoregion respectively with values of 1.23, 1.5, and 3.64. The lowest mean values of EVIG-LAI, EVIE-LAI, and NDVIE-LAI in June were observed for Kowsar (0.67), Meshginshahr (1.8), and Neur (2.70) ecoregions, and in July, the Bilesavar ecoregion, respectively, with values of 0.31, 0.31, and 0.81. High correlation and determination coefficients (r > 0.83 and R2 > 0.68) between LP 100 and remote sensing derived LAI were observed in all three PFTs (except for NDVIE-LAI in June with r = 0.56 and R2 = 0.31). On average, all three examined LAI measures tended to underestimate compared to LP 100-LAI (r > 0.42). The findings of the present study could be promising for effective monitoring and proper management of vegetation and land use in the Ardabil Province and other similar areas.

Adriana Nieto-Sanjuanero ◽  
Arturo García-Ramírez ◽  
María Martínez-Cobos ◽  
Edmundo García-Martínez ◽  
Manuel De la O-Cavazos ◽  

<p class="abstract">The congenital absence of the nose is called arrhinia and according to the Losee et al classification, it is type I. Total arrhinia is considered if it is associated with the absence of the olfactory system (olfactory tracts and bulbs). In Mexico, there is only one reported case of arrhinia. In this case report, we presented a neonate with a congenital absence of the nose. The absence of olfactory tracts and bulbs was verified with imaging and pathological studies, classifying it as total congenital arrhinia. This case was the first of its type in our country. Since it was a rare condition, there was little bibliography on its management, therefore, coordination between the different specialties is important for proper management.</p>

Sabyasachi S. Roy ◽  
Mukul Kulshrestha

Indian Railways is the world’s largest government-owned monopoly, annually carrying passenger numbers that surpass the global population. It is world’s fourth largest rail network after the U.S.A., China, and Russia, and is managed by a separate Ministry of Railways. The operating ratios have consistently been around 90% in the past several years, indicating that that the capability to generate operational surplus is low. Further, its expenditure on staff and their pensions has been increasing. Consequently, capacity growth is increasingly being funded through borrowings, which threatens to further worsen the financial situation. Thus, railway services in India are often perceived as being inefficient and unsatisfactory. However, this perception of inefficient services has no scientific basis as mid- and micro-level efficiency analyses of Indian Railways have never been carried out. This paper adopts a data envelopment analysis (DEA)-based approach to evaluate the performance efficiencies of the 69 divisions of Indian Railways. Six models that deploy a range of performance indicators like operating expenditures, numbers of staff employed or passengers carried, freight carried, rail network length, and revenues generated have been employed to assess efficiencies. The results demonstrate the existence of significant inefficiencies that may possibly be attributed to lack of proper management, planning policies, and mis-governance, resulting in significant financial losses. The paper discusses these issues and the policy reforms needed in the developing country context, while suggesting some reforms that may lead to improved sector performances.

2021 ◽  
Vol 33 (1) ◽  
Anish Bhargav ◽  
Parminder S. Otaal ◽  
Manphool K. Singhal

Abstract Background Dual left anterior descending (LAD) coronary artery is a rare congenital anomaly. To date, eleven variants of dual LAD have been described with three published reports of type X dual LAD. Here, we describe a new variant of type X dual LAD with a short LAD artery masquerading as type 1 LAD. Case presentation A 42-year hypertensive female presented with recent onset angina with a treadmill test positive for inducible ischemia. Coronary angiography showed a normal right coronary artery (RCA). The left main coronary artery (LMCA) originated from the left sinus of Valsalva (SOV), giving rise to a LAD and the left circumflex artery (LCX). Appearing a normal angiogram with type 1 LAD based on its length, the presence of a large bare area in LAD territory (especially at the apex) and lack of septal branches prompted a search for an additional vessel. Right SOV injection showed a vessel originating separately from RCA, which was confirmed to be a long LAD on selective injection, with a pre-pulmonic course and giving rise to septal branches exclusively before wrapping around the apex. Computed tomography coronary angiography (CTCA) confirmed the pre-pulmonic course of long LAD, defined its entry to the distal interventricular septum to the right of short LAD, and ruled out other coronary artery anomalies. In the absence of a stenotic lesion in the epicardial coronaries, angina in our case was presumed to be due to microvascular dysfunction. She was discharged on beta-blocker therapy for co-existing hypertension and is asymptomatic on follow-up at one year. Conclusions A short LAD artery of type X Dual LAD could be potentially misdiagnosed as type 1 LAD based on its length. However, an active search for a long LAD could properly diagnose the case as a variant of type X dual LAD, which has important clinical implications. Its awareness is critical for cardiologists and cardiac surgeons to correctly interpret the coronary angiogram and plan proper management.

2021 ◽  
Vol 14 (3) ◽  
pp. 1654
Marcus Roberto Cascaes Rodrigues ◽  
Orleno Marques Da Silva Junior

A Zona Costeira Amapaense é uma área de com diversidade ambientes, fauna, flora e recursos naturais. Por estes fatores, esta é uma região explorada, tanto pela população costeira como pelos demais setores da economia, principalmente o setor portuário e ocupação urbana. A influência antrópica sobre esta região, em virtude de sua riqueza natural, associada às mudanças climáticas, podem alterar a dinâmica das forçantes que atuam sobre a área, consequentemente, os processos que atuam sobre a zona costeira. O objetivo desse artigo foi trazer ao público informações da Zona Costeira do Amapá de maneira que esses dados possam ser usados para melhor gerir essa importante área do estado. Assim, o conhecimento sobre os diversos aspectos da Zona Costeira Amapaense, bem como as suas características, em estudos publicados ao longo dos últimos anos, forneceu um compilado de informações a respeito da região que poderá futuramente servir como fonte de referência para o devido manejo dos recursos naturais, gestão e ordenamento territorial nessa área. Overview Of Coastal Zone of the State Of AmapáABSTRACTThe Amapaense Coastal Zone is an area with diverse environments and natural resources. To manage this space more efficiently, it is necessary to know its physical and socioeconomic characteristics, and the processes that act on the coastal zone. The purpose of this article was to bring information from the Amapá Coastal Zone to the public, in order to provide subsidies to environmental agencies that operate in the coastal zone of the state, so that this data can be used to better manage this area of the state. The Amapaense Coastal Zone stands out for its dynamism and productivity in the region, marked by the intense activity of coastal processes that constantly modify the region; the performance of erosive and depositional processes in determining the current configuration of the coastal plain; the influence of the Amazon River on sediment transport and deposition along the coastline and on the consolidation of vegetation; the performance of mangroves as a place of refuge and feeding aquatic species; and the rich biodiversity of the Coastal Zone related to climatic conditions and the phenomenon of speciation in the tropics. These factors make the Amapá Coastal Zone an explored region, both by the coastal population with extractive activities and by the sectors of the economy such as ports and services related to urban occupations. With this article we hope to provide a compilation of information about the region that may in the future serve as a reference source for the proper management of natural resources, management and territorial ordering in this area as well as a baseline for further research.

2021 ◽  
Vol 67 (No. 7) ◽  
pp. 328-337
Bahman Kiani ◽  
Kiyan Yegandoost

The regeneration of forest trees is affected by the presence, dispersion pattern and specifications of parent trees. These effects were investigated and modelled in hardwood forests in the north of Iran. To do so, at first, fifty plots, each with a total area of 0.1 ha, were identified. Four subplots with a radius of two meters were then stabilized in each plot. The height and the root collar diameter of all the cherry seedlings were measured. Likewise, the diameter, basal area, and distance from the plot centre were appraised in the parent trees. The correlation and regression analyses were performed to evaluate the effects and to construct the models, respectively. The results showed that there was a positive and significant relationship between the presence, abundance, mean diameter, and total basal area of parent trees and the presence and abundance of seedlings. The logistic regression showed that the models based on the mean diameter of parent trees and abundance of parent trees could significantly predict the presence of regeneration. Only in 10% of the sample plots was the regeneration recorded without the presence of a parent tree.  Due to the small number of established seedlings, while maintaining the existing parent trees, especially large trees, it is necessary to consider the proper management methods to promote and protect their regeneration. We recommend completing the natural regeneration of wild cherry by artificial regeneration and creating well-dimensioned canopy gaps.

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e11798
Claudia Maistrelli ◽  
Hanna Hüneke ◽  
Marion Langeheine ◽  
Oliver Keuling ◽  
Ursula Siebert ◽  

Background The wild boar population in Europe is steadily growing, one of the reasons for this increase probably being the high reproductive potential of this large mammal. Population management is important to stabilise wild boar numbers and a great deal of attention is focusing on the reasons, which might contribute to the high reproductive rates. Understanding the timing of puberty attainment provides information required for proper management practices. Knowledge of the earliest expected time of sexual maturation in male wild boars is limited, research being mostly focused on females. Previous hunting references indicate that sexual maturity in males occurs in the second year after birth. In contrast, male domestic pigs become sexually mature from about seven months of age. Thus, aims of this study were to investigate (1) whether there is a physiological ability for reproduction also in male wild boars of a younger age and (2) whether the body weight of wild boar males has a more important role than age in driving the maturation of the testis. Methods Male wild boar individuals were sampled during hunting drives in the eastern part of Lower Saxony in Germany. Testes with epididymides from 74 males were collected and prepared for histological examination and immunohistochemistry. The reproductive status could be ascertained based on development/occurrence of different germ cell populations using histology and based on the immunohistochemical detection of the anti-Müllerian hormone and androgen receptor. Results In this study, male wild boars aged nine to ten months already passed puberty and were able to reproduce if they had reached the appropriate body condition of about 29 kg dressed weight. Immunopositivity to the anti-Müllerian hormone in Sertoli cells was evident only in prepubertal animals and decreased with the onset of puberty. No immunoreaction was evident at postpuberty. The androgen receptor was detected in Sertoli cells, peritubular cells and Leydig cells, surprisingly already in Sertoli cells of prepubertal wild boars as well depending on body weight. Moreover, two-thirds of young males aged about ten months were precociously reproductively mature, showing histologically the presence of spermatozoa in testes and epididymides. Conclusions As piglets are mostly born in spring, also these young male individuals could target the heat of female wild boars in the winter months, resulting in the observed population increase. Therefore, a reduction in wild boar numbers should also focus on piglets of both sexes.

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