Frequency of language and swallowing problems in children with cerebral palsy at a tertiary care hospital Rawalpindi, Pakistan.

Objective: To investigate the occurrence of language and swallowing problem in individuals with cerebral palsy. METHODS: The cross-sectional survey was conducted at the Riphah International University, Rawalpindi, Pakistan, from September 2018 to January 2019 while data was collected from the Armed Forces Institute of Rehabilitation Medicine, Rawalpindi, a tertiary care hospital. The sample comprised individuals with cerebral palsy of either gender aged 5-18 years. Language Sample Checklist was used for language problems and the North western Dysphagia Patient Checklist was used for swallowing problems. Data was analysed using SPSS- Version 21. RESULTS: Of the 55 subjects,62% were males, 38% were females, 76% were from urban areas and 24% were from rural areas. In terms of concepts, processing, and comprehension, 18(33%) persons were able to attempt the tasks, 45(81%) were unable to attempt morphological tasks, 41(74%) were unable to attempt sentence structure tasks, 40(72%) were unable to attempt literacy and narrative skills tasks, 41(74%)could not fulfil pragmatic tasks and 49(89%) had unintelligible speech. The patient checklist showed that 47(85%) children had normal medical history, 41(75%) had normal behavioural variable, 29(52%) had normal gross motor ability,40(73%) completed oral motor test, and 39(71%) had normal swallow trials. Conclusion: Language problems were more prevalent in children with cerebral palsy compared to swallowing difficulties.

Frequency of hearing impairment in children between the ages of 2 and 10 years with middle ear infection.

This study was conducted on children between 2 and 10 years age to determine the frequency of hearing impairment in middle ear infection. It was a cross-sectional survey, done at Riphah International University from August 2018 to January 2019. Data was collected from the ENT Department of Children's Hospital Lahore through convenience sampling technique and included 52 patients with middle ear infection. Measurements for the level of hearing impairment were taken, and data was analysed using statistical package for social sciences, SPSS 20.0. Of the total 52 patients, 15 (28.8%) had ear infection once a month and 37 (71.2%) had it off and on. Mild hearing loss was determined in 35 (67.3%) patients,13 (25%) had moderate, 2 (3.8%) severe and 2 (3.8%) had normal hearing. It was concluded that most of the children with middle ear infections developed hearing loss.

Perception of speech and language pathologists towards augmentative and alternative communication in Pakistan.

OBJECTIVE: To determine the level of understanding and use of augmentative and alternative communication devices in Pakistani speech pathologists.. METHODS: The cross-sectional survey was conducted from January to June 2015 in six major cities of Pakistan: Islamabad, Rawalpindi, Lahore, Karachi, Quetta and Peshawar. It comprised speech and language pathologists who were asked to fill a questionnaire that consisted of10 questions. Data was analysed using SPSS17. Result: Overall calculated mean and standard error of mean from the respondents who agreed and strongly agreed regarding understanding, opinion-assessment and treatment about augmentative and alternative communication was153±36.373 and 12.124 respectively. RESULTS: Of the 132 subjects, 68(51.5%) were in the education group and 64(48.5%) in the control group. Postintervention, 11(16.2%) women in the education group and 37(57.8%)in the control group developed severe preeclampsia. Subsequently, 44(64.7%) in the education group had no preeclampsia. The corresponding number in the control group was 15(23.4%). CONCLUSIONS: Speech pathologists had understanding of assessing and working with individuals using augmentative and alternative communication.

Antidepressant Use and Depressive Symptoms in Intensive Care Unit Survivors.

Nearly 30% of intensive care unit (ICU) survivors have depressive symptoms 2-12 months after hospital discharge. We examined the prevalence of depressive symptoms and risk factors for depressive symptoms in 204 patients at their initial evaluation in the Critical Care Recovery Center (CCRC), an ICU survivor clinic based at Eskenazi Hospital in Indianapolis, Indiana. Thirty-two percent (N = 65) of patients had depressive symptoms on initial CCRC visit. For patients who are not on an antidepressant at their initial CCRC visit (N = 135), younger age and lower education level were associated with a higher likelihood of having depressive symptoms. For patients on an antidepressant at their initial CCRC visit (N = 69), younger age and being African American race were associated with a higher likelihood of having depressive symptoms. Future studies will need to confirm these findings and examine new approaches to increase access to depression treatment and test new antidepressant regimens for post-ICU depression.

Experimental study of direct laser deposition of Ti-6Al-4V and Inconel 718 by using pulsed parameters.

Laser direct metal deposition (LDMD) has developed from a prototyping to a single metal manufacturing tool. Its potential for creating multimaterial and functionally graded structures is now beginning to be explored. This work is a first part of a study in which a single layer of Inconel 718 is deposited on Ti-6Al-4V substrate. Single layer tracks were built at a range of powder mass flow rates using a coaxial nozzle and 1.5 kW diode laser operating in both continuous and pulsed beam modes. This part of the study focused on the experimental findings during the deposition of Inconel 718 powder on Ti-6Al-4V substrate. Scanning electron microscopy (SEM) and X-ray diffraction analysis were performed for characterization and phase identification. Residual stress measurement had been carried out to ascertain the effects of laser pulse parameters on the crack development during the deposition process.

Nitrogen oxides emission control options for coal-fired electric utility boilers.

Recent regulations have required reductions in emissions of nitrogen oxides (NOx) from electric utility boilers. To comply with these regulatory requirements, it is increasingly important to implement state-of-the-art NOx control technologies on coal-fired utility boilers. This paper reviews NOx control options for these boilers. It discusses the established commercial primary and secondary control technologies and examines what is being done to use them more effectively. Furthermore, the paper discusses recent developments in NOx controls. The popular primary control technologies in use in the United States are low-NOx burners and overfire air. Data reflect that average NOx reductions for specific primary controls have ranged from 35% to 63% from 1995 emissions levels. The secondary NOx control technologies applied on U.S. coal-fired utility boilers include reburning, selective noncatalytic reduction (SNCR), and selective catalytic reduction (SCR). Thirty-six U.S. coal-fired utility boilers have installed SNCR, and reported NOx reductions achieved at these applications ranged from 15% to 66%. Recently, SCR has been installed at >150 U.S. coal-fired utility boilers. Data on the performance of 20 SCR systems operating in the United States with low-NOx emissions reflect that in 2003, these units achieved NOx emission rates between 0.04 and 0.07 lb/10(6) Btu.