The management of autism spectrum disorder requires a multidisciplinary team (MDT) comprising parents, therapists, psychologists, special educators, and medical specialists. Therapy is aimed at helping the child acquire functional skills in daily living, to minimize the core features of autism, and eliminate behaviors that are unhelpful or disruptive. The child must be adequately assessed by every member of the MDT to formulate an intervention plan which is then brought together to tailor a specific treatment plan for each child. The involvement of the parents or caretakers in the entire process is critical. The plan should address multiple areas such as communication, social skills, behavior, daily living, motor skills, and learning early and intensive treatment has been shown to be much more effective than treatment that is delayed. The child's progress should be monitored and documented, and only then can the intervention model's effectiveness be gauged.

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Autism spectrum disorder (ASD) is a neurodevelopmental disorder of behavior that presents in childhood. It is a clinically heterogeneous disorder of behavior, characterized by two features - (1) impairment in social communication and interaction and (2) repetitive patterns of behavior. The diagnosis is essentially clinical and is based primarily on history-taking and observation of the child over a period. There are several standardized screening tools and scales available to help make a diagnosis. Children with autism often present with speech delay and this has to be distinguished from other conditions. ASD is often associated with comorbid conditions which have to be identified to tailor the treatment program for each child. It is important that the parents or caretakers of the child are involved in the process of assessment and diagnosis and that their misconceptions and fears are addressed.

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Autism affects up to 1 in 250 children. Early intervention programs combining behavioral and developmental training are the current standard of care. In this article, the role of medication in children and adolescents with autism spectrum disorders (ASDs) is discussed. We highlight the key symptoms that can be targeted with medication-based treatments. An approach to treatment is based on available guidelines which includes clinical assessments, addressing comorbid conditions, planning investigations prior to starting pharmacotherapy, choosing suitable pharmacological agents, and subsequent monitoring while on medication. Risperidone and aripiprazole continue to be the only approved medications. Continued support and counseling of caregivers after starting medication includes discussions on monitoring behavioral change along with any adverse effect and discussing further referral when needed. Primary care physicians in India are an important resource in the absence of developed systems for the management of developmental disabilities. Early referral to specialists for initial diagnosis and developmental interventions cannot be overemphasized. However, a community-based follow-up model for continued care of children and adolescents with ASD that includes primary care physicians can be implemented.

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A toddler is suspected to have autism when the child shows atypical behavior mannerisms, delay in acquiring language skills, avoidance of normal learning process, or atypical motoric mannerisms. The evaluation and management of such a child will require a careful step-by-step approach starting with the observation of the child, identifying possible causative pathways, management of parental dilemmas, investigations, and integrative therapy and support. The evaluation and follow-up of a child with autism is an unfolding process that takes years of a holistic approach which integrates the services of experts from multiple disciplines is essential. The therapy of a child with autism has to be tailored to the specific needs of the child as every child responds differently to therapy. The involvement of the parents and the entire professional team throughout the process is essential for optimal evaluation and management.

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In the setting of blunt or penetrating injury to the abdomen and chest, bedside ultrasound in the form of the extended-focused assessment with sonography for trauma (E-FAST) examination plays a vital role in rapid diagnosis of bleeding in the abdominal and thoracic cavities. Rapid diagnosis and intervention based on the diagnosis is associated with better treatment outcomes. E-FAST is rapid, can be done along with the primary and secondary survey without disrupting resuscitative measures, is noninterventional, and does not involve exposure to ionizing radiation. It can be used to detect hematoma in the intraperitoneal cavity and pelvis, hemothorax, pneumothorax, and pericardial effusion using eight standard views. The disadvantages are that it is operator dependent and requires some amount of training, and a negative E-FAST study does not necessarily exclude serious intra-abdominal injury.

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Background: Health-care workers have a major role to play in ensuring that malaria treatment is carried out in accordance to treatment guidelines, to ensure the quality of patient care. Having the requisite knowledge of the ailment and its management is a necessity in achieving optimal treatment outcomes. Objectives: The purpose of this study was to assess and compare health-care workers' knowledge on malaria and its treatment across public and private primary health-care facilities of Bassa Local Government Area, Nigeria. Materials and Methods: Two hundred pretested semi-structured questionnaires were administered to health-care workers across selected public and private facilities; and the generated data were analyzed using Statistical Package for Social Sciences software version 20. Results: A total of 184 health-care workers (92% of the study population of 200) participated in the study. The majority of the health-care workers (65.8%) were from the public sector, while 34.2% were from private health facilities. Most of the respondents were Junior Community Health Extension Workers (23.4%) and Community Health Extension Workers (22.8%). The other health workers included in the study were nurses and laboratory and pharmacy technicians involved in the management of malaria. The respondents had a good knowledge of the cause, symptoms, and diagnosis of malaria across the facilities, based on their item scores; however, their knowledge on anti-malarial drugs was poor. Workers with >10 years in practice had significantly better knowledge (45.3%) than those with lesser experience (28.4%) (P = 0.018). Those in private practice had marginally better knowledge (44.4%) than those in public sectors (38.8%). Conclusion: The respondents had good knowledge of the etiology, symptoms, and diagnosis of uncomplicated malaria across the facilities, but knowledge of the recommended antimalarials and symptoms of complicated malaria was poor. The outcomes will be useful in educating health-care professionals in the facilities, with an emphasis on the recommended drugs for malaria.

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Echinococcosis or hydatid disease caused by the larval stage of cestodes of the genus Echinococcus granulosus, produces cystic lesions in various organs, the liver being the most common site. Symptoms are produced by mass effect, biliary obstruction, or secondary infection in most instances. Cystic rupture is an uncommon cause of symptoms. We report the uncommon occurrence of pneumobilia in the setting of hydatid cyst rupture with secondary infection by gas producing organisms.

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