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Summary: The exact incidence of carbon monoxide (CO) poisoning in Nigeria is unknown. Globally, CO poisoning is frequently unrecognized and under-reported since the clinical presentation is relatively non-specific. The circumstances usually involve an unsuspected increase of CO in an enclosed environment. We .. present the case of a five-year old girl who was brought to the Emergency Paediatics Unit with altered consciousness and profound muscle weakness following exposure to exhaust fumes from a petrol powered electric generator. The generating set was usually operated within the kitchen during the preceding year, but on that particular day, a large refrigerator was placed beside the kitchen door thereby preventing its complete closure. She made an uneventful recovery following treatment with 100 percent oxygen. The case highlights the susceptibility of children to CO poisoning caused by operating petrol powered electric generators within the house. Health education of the community is necessary to avert such hazards.

Social science researchers have endeavored with the literature showcasing various individual mobile recommendation systems to assist stakeholders in the tourism sector. The challenge of formulating a mathematical equation to predict tourist growth at specific sites arises due to the diverse environmental conditions unique to each destination. This research seeks to develop a mobile application model fostering connectivity among significant tourism stakeholders. Within the app, stakeholders can effortlessly retrieve information about others and directly engage with relevant authorities without exiting the application. The app also provides navigation guidance to tourist destinations. The study explores the specific growth rate of tourists, assuming a doubling of tourist numbers after a specific time interval has been illustrated. While there may be an initial exponential growth in tourist numbers at a destination, the count eventually stabilizes. The Monod equation is employed in conjunction with the tourist equation for a comprehensive representation in this study. Additionally, the research delves into the graphical analysis of the feasibility conditions proposed by Casagrandi and Rinaldi's connectivity model. It is essential to note that this analysis remains abstract, and the creation of a universally applicable mathematical tourism model for every destination proves nearly impossible.

Study DesignRetrospective case study by clinical and radiological data analysis.PurposeTo analyze different types of vertebral anomalies and the incidence of associated intraspinal anomalies in the Indian population.Overview of LiteratureThis is the largest study of congenital scoliosis and associated intraspinal anomalies in Indian population. Incidence of intraspinal anomaly in this series is 47% which is higher than previous literature. Hemivertebra was the most common anomaly as seen in previous studies.MethodsA total of 119 patients with congenital scoliosis who underwent surgery between December 2006 and December 2012 were studied. Data was reviewed with medical records, plain radiographs, and magnetic resonance imaging (MRI) scans.ResultsThoracolumbar curve was most common, seen in 43.6% of patients. In addition to scoliotic deformity, kyphosis was seen in 26% of patients. Failure of formation, the most common vertebral anomaly, was seen in 51.2% of patients, failure of segmentation was seen in 19.3% of patients, and there were 29.4% patients having both formation and segmentation anomalies. Hemivertebra was the most common vertebral anomaly seen in 66.3% of patients and for whom 63.2% were in thoracic spine. Intraspinal anomalies were associated with 47% of patients with congenital scoliosis. Tethered cord was the most common intraspinal abnormality and was found in 48.2% patients with intraspinal anomalies. The patients with failure of segmentation and mixed deformities were found to have a significantly higher incidence of intraspinal anomalies (65% and 57%, respectively) than those with failure of formation (34%). Out of 31 patients with kyphotic deformity 29% had intraspinal anomalies, and amongst them tethered cord was the most common anomaly seen in 66% patients. Out of 12 patients with neurocutaneous markers, 83% patients had intraspinal anomaly.ConclusionsIntraspinal anomalies were seen in 47% of patients with congenital scoliosis in the Indian population. Tethered cord was the most common intraspinal anomaly, seen in 48% cases of congenital scoliosis. Hemivertebra was seen in 66% cases and was the most common vertebral defect. Hence MRI imaging of whole spine should be done in all cases of congenital scoliosis before any surgical intervention. Special attention should be given to physical examination and visualization of any neurocutaneous markers, which are associated with a higher incidence of intraspinal anomalies; absence of a neurocutaneous marker, however, does not rule out intraspinal anomaly.

Background: Government Hospital of Thoracic Medicine, Tambaram Sanatorium, Chennai, is the largest HIV-care center in South East Asia. As many as 29,300 HIV patients visited this center at least once in the year 2005 for care and support. Objectives: Clinical manifestations and the modes of presentation of tuberculosis were assessed among 12,750 adult and adolescent patients with human immunodeficiency virus (HIV) attending the hospital for the first time. Materials and Methods: Database of Hospital Information System, specially evolved for managing patients afflicted with tuberculosis and HIV, was utilized. The particulars confined to patients with tuberculosis and HIV co-infection who visited the hospital for the first time from January to December 2005 were considered for the analysis. Proportion test and Chi-square test with Yates correction were done. Results: As many as 12,750 adult and adolescent HIV-confirmed patients were screened for the possible presence of tuberculosis. Out of them, 4,383 (34.4%) patients had tuberculosis. Among them, 2,448 (55.9%) had pulmonary tuberculosis, and the remaining 1,935 (44.1%) had either disseminated or extra-pulmonary tuberculosis (P< 0.001). Positive sputum-smear microscopy for acid fast bacilli was evident in 1,363 (31.1%) patients; however, it was significantly lower compared to positive smear rate of 44% in HIV patients (P< 0.001). Conclusion: Tuberculosis was found to be the predominant co-infection among the symptomatic patients infected with HIV attending the largest care center for the first time in India. Advanced tuberculosis, disseminated tuberculosis and sputum smear negative pulmonary tuberculosis were the presenting clinical manifestations in 44% of the patients, as they had moderate to advanced immunosuppression. Early detection of tuberculosis co-infection is absolutely necessary.