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Durian peel can be the main contributor to agricultural wastes and becomes an environmental problem when it is discarded into the landfill site or even burning it. The average of entire durian fruit weight is about 255,353 MT for all over the country. The loading rate of landfills is increasing, especially with the massive amount and size of the durian waste that requires a larger space to dispose of. Therefore, it is certainly important to utilize durian husk as an adsorbent to improve water quality, especially groundwater source. Groundwater commonly has a higher hardness level than surface water. The higher hardness in water becomes a major concern, especially in every cleaning task. This research aimed to investigate the potential of durian husk in reducing water hardness, electrical conductivity (EC), and total dissolved solids (TDS). Durian husk was treated with NaOH solution to improve adsorption efficiency. Laboratory analyses such as the ethylenediaminetetraacetic acid (EDTA) titration method were performed for the water hardness, total dissolved solids, and conductivity concentrations respectively to test the performance of the removal efficiency before and after the treatments. As the results, the removal of hardness concentrations by durian husk has significantly dropped with dosage and settling time. However, not for TDS and EC concentrations removal, which it went sudden increased for a higher dosage. The novelty of this study is that it is the first-ever experiment using the real on-site samples in the field as for initial concentrations, different from other previous studies by lab-scale the synthetic hard water and most of them using the highest concentration of hardness which up to 700 mg/L of CaCO3 as to find out the removal efficiency for water softening in water treatment using durian husk, compare to this study using a concentration that is too low within 300 mg/L and below.

Extensive grassroots exploration along the southern coast of Mozambique has resulted in the discovery of significant titanium heavy mineral (HM) sand mineralisation and subsequent definition of the large Mutamba deposit, within the Jangamo and Inharrime districts of Inhambane Province. As part of the economic assessment a geological model of the deposit was developed and this has contributed to a better understanding of Quaternary coastal evolution within the area of the Inhambane Peninsula. The correlation of geomorphological and geological characteristics of the deposit area, which included analysis and interpretation of satellite and air photo imagery, field observations, drill sample observations (reverse-circulation, hand-auger, sonic and vibracore) of sand texture and laboratory analyses for total HM and slime content, has resulted in identification of a stratigraphic sequence of mixed marine–continental origin deposited in a marginal-marine environment. Understanding the stratigraphy and geographic...

Cerebro-retinal microangiopathy with calcifications and cysts (CRMCC) or Coats plus syndrome is a pleiotropic disorder affecting the eyes, brain, bone and gastrointestinal tract. Its primary pathogenesis involves small vessel obliterative microangiopathy. Recently, autosomal recessively inherited mutations in CTC1 have been reported in CRMCC patients. We herein report an adolescent referred to our hospital following new seizures in a context of an undefined multisystem disorder. Cerebral imaging disclosed asymmetrical leukopathy, intracranial calcifications and cysts. In addition, he presented other typical CRMCC features i.e. a history of intrauterine growth retardation, skeletal demineralization and osteopenia, bilateral exudative vitreo-retinopathy reminiscent of Coats disease, recurrent gastrointestinal hemorrhages secondary to watermelon stomach and variceal bleeding of the esophagus due to idiopathic portal hypertension and telangiectatic and angiodysplasic changes in the small intestine and colon, and anemia due to recurrent bleeding and bone marrow abnormalities. The patient was diagnosed with Coats plus syndrome. CTC1 gene screening confirmed the diagnosis with the identification of heterozygous deleterious mutations. CRMCC due to CTC1 mutations has a broad clinical expressivity. Our case report illustrates the main possible associated phenotypes and their complications, demonstrating the need for a careful etiological search in order to initiate appropriate therapeutic and preventive measures.

Probleme majeur de sante publique, les tentatives de suicide des adolescents appellent une mise en sens. Il nous semble que le geste suicidaire manifeste une voie de decharge pulsionnelle retournee contre soi tout en preservant l’objet et peut etre compris comme une defense violente instinctuelle. Le courant sexuel instinctuel pubertaire insuffisamment contenu se voit excessivement infiltre par des motions infantiles parenticides et incestueuses non integrees, en echo a des motions infanticides assignees aux figures parentales, ce qui est susceptible de brouiller les reperes generationnels. Ainsi, le geste suicidaire nous semble signer momentanement un echec d’elaboration du traitement de la perte et du conflit œdipien reactualise a l’adolescence mais nous semble aussi signer une tentative de redemarrage du processus de subjectivation. Notre propos s’etaye sur des extraits d’entretiens cliniques d’une adolescente de 16 ans, apres son passage aux urgences a la suite d’un geste suicidaire par ingestion medicamenteuse et sur une comparaison de deux sequences de reponses au T.A.T., peu apres le geste suicidaire et un an plus tard.

La pubertad representa un periodo clave para la persona joven en su trayectoria de crecimiento, pero tambien para el medico en lo que se refiere a la identificacion de posibles retrasos o de algunas afecciones. Esta etapa fundamental del desarrollo, en parte geneticamente determinada y de aparicion mas temprana en las ninas, es el inicio de la entrada en la adolescencia y se produce a una edad variable. Los efectos mas relevantes de la pubertad son la aceleracion de la velocidad de crecimiento estatural, el desarrollo de los organos genitales y de los caracteres sexuales secundarios, y el aumento de la masa corporal total. Por efecto de las hormonas gonadales, la metamorfosis puberal proyecta al nino, en pocos anos, hacia un cuerpo de adulto sexuado y apto para la procreacion. En consecuencia, acarrea modificaciones psicologicas profundas, cambios en las relaciones con los padres y, de manera mas amplia, una mayor participacion social. Las transformaciones de indole afectiva y conductual, propias del inicio de la adolescencia, se explican en parte por la accion directa o indirecta de las hormonas puberales. La cronologia puberal y sus diferencias ejercen, mucho mas que las etapas de la pubertad, efectos positivos o negativos que varian segun el sexo. Los adelantos o retrasos puberales son un motivo de consulta frecuente. Aunque muchas de estas situaciones solo reflejan la dispersion estadistica natural, algunas son realmente patologicas y deben tratarse. Este es el caso, sobre todo, de las pubertades precoces en el nino y de los retrasos puberales en la nina.

inpatients. The nutritional care of a severely emaciated anorexic adolescent can be performed in any pediatric ward. This article is a practical guide which reminds the indications, mostly clinical, for hospitalization and the way to achieve a progressive but efficient renutrition. We wish to share our own practical experience while focusing on acute nutritionnal care, according to the aim of this section of the journal.

Many adolescents are sexually active and reproductive health is an important aspect of adolescent medicine. However, pediatricians are often uncomfortable with the issues of sexuality and contraception, for which they have not been particularly trained. The general purpose of this article is to increase pediatricians' sense of competence with adolescents, particularly when having to deal with or councel on such a sensitive issue as contraception. This second of two parts adresses confidentiality and prescription of oral contraceptives to minors, how to ask questions about sexual and reproductive life, best initial choice and eventual subsequent switch of contraceptive pill, acne and oral contraception, problems with mental handicap, and finally, what about boys. Pediatricians interested in the care of adolescents are strongly invited to keep developing their expertise in the field of sexuality, contraception and reproductive health.

L'observance, autrement nommee compliance, adherence ou fidelite therapeutique, est definie comme « le degre de concordance entre le comportement d'un individu (en termes de prise medicamenteuse, suivi de regime ou de changements de style de vie) et la prescription medicale[7]. Les travaux sur l'observance therapeutique des adolescents concernent principalement les traitements des maladies chroniques, la contraception orale et les rendez-vous de consultation. Distincte de l'alliance therapeutique, l'observance est un domaine privilegie d'expression des malentendus possibles dans la relation de soins avec les adolescents. Nous n'aborderons ici que les aspects medicaux somatiques de la question, mais rappellerons pour memoire que l'observance avec le « psy(consultations, psychotropes) est un theme egalement important a l'adolescence [1].

La puberte vient rompre le processus lineaire de croissance de l'enfant. Elle marque l'entree dans l'adolescence et contribue a en edifier la plupart des aspects [1]. A cette occasion, de multiples questions ne manquent jamais d'assaillir l'enfant tout comme ses parents. La pratique clinique aupres des adolescents est toujours empreinte de ce melange de curiosite et d'inquietude a propos d'une metamorphose et d'un corps qui, a present non seulement sexue mais incertain dans son devenir, est devenu le centre des preoccupations. Certes, adolescent et parents ne partageront pas forcement le meme niveau d'interrogation : elle ou lui inquiet de tel ou tel aspect de l'apparence ou du developpement sexuel, mere ou pere plutot soucieux du comportement a table ou des horaires de sommeil, etc.

In clinical practice, non-compliance is an often unrecognised or frustrating reality, which physicians find difficult to accept or deal with. Possible determinants of adolescents' level of compliance may be divided into demographic factors, patient and family characteristics, aspects of the illness and treatment regimen, and quality of the patient-doctor relationship. Compliance should be viewed as a reflexion of the experience of chronic illness as well as the expression of specific adolescent developmental issues. Practical guidelines are proposed.

Resume Le paracetamol, absorbe en grande quantite, est responsable d'une defaillance hepatocellulaire aigue parfois mortelle. La faible disponibilite des greffons hepatiques invite les cliniciens a rechercher de nouvelles strategies therapeutiques. Observation.- Une adolescente de 17 ans a ete hospitalisee pour somnolence et vomissements. Les examens toxicologiques sanguins ont revele la presence de benzodiazepines et une paracetamolemie a 120 mg/l. Un traitement par la N-acetyl-cysteine par voie veineuse a ete instaure de maniere retardee (H15) et prolongee (sur 28 heures). L'insuffisance hepatique aigue a conduit au transfert de cette patiente dans un service de transplantation, mais l'evolution ulterieure a ete favorable. Conclusions.- Le traitement par la N-acetyl-cysteine est efficace meme s'il est entrepris tardivement. La prise en charge d'une insuffisance hepatocellulaire aigue impose des bilans repetes de l'hemostase. Le deficit en facteur VII, qui est le premier a se corriger en cas d'evolution favorable, pourrait guider l'attitude therapeutique.

Resume Internet propose des informations interessantes sur le theme de la sante. Cet article presente une selection de sites en francais destines aux jeunes gens sur les themes de la sante et la sexualite, que les pediatres pourront recommander a leurs patients adolescents. Ces adresses et leur contenu meritent une verification reguliere, sachant que celle des auteurs date de janvier 2003

Depuis quelques annees, l'opinion a pris conscience du probleme des victimes de violences, en particulier lorsqu'il s'agit d'enfants. Pourtant, les violences a caractere sexuel ont garde jusqu'a tres recemment le triste privilege de rester pratiquement sous silence.

To study short-term compliance with follow-up care in a sample of adolescent suicide attempters.One hundred and sixty-seven adolescents, aged from 13-18 years and hospitalized after a suicide attempt, completed a questionnaire that included the CES-Depression Scale and Zung Anxiety Scale. Physicians assessed the hospital care immediately after the attempt, and post-discharge care plans. Three months later, adolescents were contacted by telephone and asked about follow-up care.After 3 months, 91.6% of the adolescents could be contacted: 25.5% never attended any follow-up; 11.1% went only once; 31.4% missed some appointments; and 32.0% went to all their scheduled appointments. Adolescents who complied with follow-up care differed significantly from those who did not: they showed more depression, anxiety and illicit drug use at the time of the attempt; they had more often planned the attempt; they were hospitalized longer; and they met with a psychiatrist more often while hospitalized. Compliance was also better when the follow-up appointment was scheduled before discharge.Compliance with post-discharge follow-up care depends upon the adolescent's psychopathology but may also be improved by the type of hospital care and post-discharge plans.