Hidden aspects of child abuse.

Child abuse related to witchcraft and exorcism phenomena is not limited to specific cultures, religious beliefs, races and geographic areas and it can be seen in all periods of human culture and civilization. Despite the widespread consequences of harm, due to the limited reports and announced statistics, the scope of the problem in comparison to other forms of child abuse seems minor. The legal and judicial services are often unaware of these cases and it is not highlighted in police and social service databases as a significant factor in child abuse. In spite of global programs on children's peace and activities of child rights committee of United Nations, this type of hidden child abuse continues. In this study, we have discussed seven cases of child abuse related to these phenomena and address the psychological dimensions of the injury by The Revised Children's Anxiety and Depression Scale and Subscales (RCADS) that showed clinically significant anxiety and depression. In addition, we have tried to look at the historical background, risk factors, extent of damage and challenges in the reporting field. Children are the future makers of the world, and any type of child abuse has adverse effects on their growth, physical and mental health. To confront this issue, strengthening partnerships between child protection institutions and multimodal approaches in collaboration with local, national and international organizations also imposing strict punishment on the people who played a role in this action should be pursued more seriously.

Radiation-Free myeloablative allogeneic hematopoietic stem cell transplantation for adult acute lymphoblastic leukemia: A comparison of outcomes between patients with and without central nervous system involvement.

For patients with acute lymphoblastic leukemia (ALL) undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT), total body irradiation (TBI) has been particularly advocated as a part of the conditioning regimen in case of extramedullary involvement in sanctuary sites such as the central nervous system (CNS), to ensure greater tissue penetration. In resource-limited countries lacking TBI facilities; however, ALL patients undergo radiation-free myeloablative conditioning, though its impacts on post-HSCT outcomes of the patients with pre-HSCT CNS involvement have not been analyzed. In this 14-year series of 278 adult (> 18 y) ALL patients undergoing TBI-free busulfan/cyclophosphamide conditioning allo-HSCT, we found that the long-term probabilities of overall survival, disease free survival, relapse and non-relapse mortality were not significantly different between CNS-involved and CNS-spared patients. Moreover, there was no statistically significant difference in the incidence of post-HSCT CNS relapse between CNS-involved and CNS-spared patients. Pre-HSCT cranial radiation therapy (CRT) showed no significant preventive effect on the likelihood of post-HSCT CNS relapse. Through multivariable regression analysis, grade III-IV acute graft-versus-host disease (GvHD), extensive chronic GvHD and post-HSCT relapse were ascertained as independent determinants of mortality (Adj.R2 = 53.9 %, F(12,265) = 28.1, P < 0.001), while other parameters including Philadelphia translocation, pre-HSCT CNS involvement and CRT were found to have no independent effect. Although this study was not an attempt to compare TBI-based vs. non-TBI conditioning, the TBI-free myeloablative allo-HSCT was shown to be feasible and an option for adult ALL patients with CNS involvement, considering the comparable outcomes between patients with and without CNS involvement.