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The study aims to examine the self-esteem level of private college teachers (permanant or visitind) of district Faisalabad, Pakistan. To accomplish the purpose of the study 100 questionnaires were sent to 5 well known educational institutions of city Faisalabad, Pakistan. The result from the study indicates that symbolic varations are there in level of self-esteem between permamnant and visiting faculty members of the private colleges. This study also shown that the permamant faculty members have high self-esteem as compared to visiting faculty members. They scored more on satisfaction, ability to do things.

A 9-year-old boy with sickle cell disease (SCD) was presented to the emergency department with acute headache and swelling over his bilateral temporoparietal region. There was no history of antecedent trauma, fever, vomiting or other features of an intercurrent illness. On arrival, his blood pressure was 112/62 mm Hg, heart rate was 98/min and his Glasgow Coma Scale score was 15/15. There was evidence of significant scalp tenderness over the bilateral temporoparietal region. A complete neurological examination including direct and consensual pupillary response was unremarkable. Initial investigations revealed haemoglobin of 9.6 g/dL, leucocyte count of 6.8/mm 3 , platelet count of 219/mm 3 and a normal coagulation profile. His current medications included hydroxyurea and penicillin prophylaxis. He underwent an urgent CT of the head followed by MRI of the brain, which revealed abnormalities as depicted in figures 1,2. Question 1 Is this one of the most common neurological presentation seen in sickle cell crisis? Question 2 How common is this presentation in paediatric SCD? Question 3 What is the best way to manage this child?