#nlc tenders

[chicagocubsreactions]

Rosenthal: For the Cubs, the value of team chemistry is worth the price of a team dinner

[original article]

The Cubs are interesting not because of an 11-6 start. No, they’re interesting because of how they are forming their own unique bond.

Well, the Cubs are saying it, along with the Pirates, Rays and perhaps just about every team except the indentured-servant A’s. Normally I would pay no mind to such happy talk, considering every clubhouse is one long losing streak from turning into a hostile work environment. But the Cubs are interesting, and not because they’re off to an 11-6 start. No, they’re interesting because of how their 2016 World Series championship team lost its mojo, and how this group is forming its own unique bond. “(The front office) has done such a good job of bringing in good humans,” Dansby Swanson, the $177 million free-agent shortstop, said of the team’s front office. “Good things can happen when you put good people together.” Let’s not overstate this. Talent matters most. A talented team with bad chemistry can win a Series. An untalented team with great chemistry stands no chance. The Cubs are playing well not because of team dinners they’re enjoying on the road. Their 2.96 rotation ERA, first in the NL, is a bigger reason. So is the club’s defensive improvement, from 21st in the majors in defensive runs saved last season to 12th in the admittedly small sample of the first three weeks.

Still, almost everyone in uniform understands the value of clubhouse dynamics, and most everyone in front offices does, too. Those dynamics cannot be quantified, frustrating the numbers crowd to the point where some remain skeptical of their importance, if not outright dismissive. But while Cubs president of baseball operations Jed Hoyer and general manager Carter Hawkins acquired players mostly for their baseball ability the past two offseasons, they also settled on a certain type. Swanson is one of six 2022-23 additions, along with Cody Bellinger, Edwin Rios, Eric Hosmer, Trey Mancini and Yan Gomes, who played for at least one World Series champion. Marcus Stroman and Jameson Taillon both pitched in League Championship Series. Seiya Suzuki competed in two Japan Series. Even backup catcher Tucker Barnhart has postseason experience. Combine those players with the recently extended Nico Hoerner and Ian Happ, two homegrown Cubs with impeccable work ethics and high baseball IQs, and it’s easy to see a strong collective makeup taking shape. Oh, and let’s not forget, manager David Ross was a two-time World Series champion as a player, while first base coach Mike Napoli appeared in three Series, winning with Ross in Boston in 2013. Some of the Cubs’ free-agent signings last offseason were more the product of timing than some grand plan. Swanson was the last big-name shortstop available. Hosmer was a bargain with the Padres paying virtually all of his salary. Mancini lingered on the market until his price dropped to two years, $14 million. And with Bellinger, a reasonable one-year, $17.5 million gamble after the Dodgers non-tendered him, the Cubs knew they would get a motivated player. It’s only 17 games, slightly more than one-tenth of the season. But so far, the pieces seem to fit. “(The Cubs) had a really good second half last year, a lot of good momentum heading into this season,” Hosmer said, referring to the team’s 39-31 record after the All-Star break. “They felt good about their roster, brought in veteran guys to help with some of these everyday guys, bring energy and some veteran experience. I think it has been a great mix.” The 2015 Cubs, who advanced to the NLCS, demonstrated the intangibles common to teams on the rise. The 2016 Cubs, who won the Series, had those qualities in abundance. But in the years that followed, those teams grew less focused, even distracted. The players perhaps grew too comfortable under manager Joe Maddon’s relaxed leadership. Potential contract extensions and trade rumors became part of the team’s daily conversation. During the 2018-19 offseason, the team’s top executives, Theo Epstein and Hoyer, embarked upon a mission to improve the team’s attention to detail. The plan did not work. The Cubs parted with Maddon after the 2019 season. One by one, most of the key players who helped the team end its 108-year championship drought left either through trades or free agency. The hiring of Ross was the first step toward restoring order, at least at the major-league level. The Cubs also sought to rebuild their farm system, a plan that had the convenient byproduct of helping them save money. From 2016 to 2020, owner Tom Ricketts carried a top-six Opening Day payroll, according to Baseball Prospectus. In the past three seasons, the team has ranked 12th, 14th and 11th. The relatively modest extensions for Hoerner (three years, $35 million) and Happ (three years, $61 million), combined with the free-agent signings of Suzuki (five years, $85 million) and Swanson (seven years, $177 million) give the Cubs four position-player cornerstones through at least 2026. In each case, the player’s makeup was a critical component. Club officials do not expect any of them to waver in their attention to detail. “They’re such good workers,” Hoyer said of the four at the news conference announcing Happ’s extension. “It makes me feel good coming in every day knowing that those guys are so well-prepared and they’re going to have a great influence over the next group as well.” With that type of nucleus, bonding comes easier. The protocols Major League Baseball implemented during the COVID-19 pandemic during the 2020 and 2021 seasons largely prevented players from getting together in groups once they left the park. But those restrictions are no longer are in place. Hosmer said the first team gatherings took place at the Cubs Convention in January. Ross organized a team outing to Topgolf after the first workout of spring training in Mesa, Ariz. Since the start of the season, the players have organized several team dinners, most recently Sunday night in San Francisco, in between series against the Dodgers and A’s. Taillon said he, Hosmer and Bellinger split the bill for that meal. Drew Smyly paid for another in Los Angeles, Kyle Hendricks yet another in spring training. Sometimes the pitchers and catchers get together. Other times, it’s the entire club. “Someone said something like, ‘Man, we’ve already had three or four team dinners. That’s three or four more than we had last year.’” Taillon said. “You bring in veterans, guys who have been in winning organizations, that’s the stuff that happens.” Said Gomes, “We’re not forcing it. We’re just making it very natural. And guys are enjoying each other.” Why does any of this matter, you ask? What’s the tangible difference when players get along compared to when they don’t? Ross points to players putting the team first and accepting their roles, as evidenced by Hosmer, Rios and Luis Torrens understanding they occasionally will be removed for pinch-hitters. Taillon provides an even more hands-on example, detailing the ways in which players can help each other. “If I go to dinner with a bunch of guys and we have a good relationship and hang out every night, I’m comfortable going up to Justin Steele and saying, ‘Hey dude, I watched your bullpen today and I saw this, this and that.’ If you don’t have the next-level relationship, I wouldn’t be able to do that,” Taillon said. “That’s what me and (Joe) Musgrove had in the past in Pittsburgh. We watched each others’ bullpens. We hung out together all the time. If he would come to me with something, I trusted him and knew it was coming from the right place. As opposed to, if you’re never hanging out with your teammates, you’re not getting along and someone comes up to you, you might be defensive.” Taillon will take the same approach with position players he connects with, perhaps making a point on how opponents are attacking them. Swanson, who benefited from positive cultures both in college at Vanderbilt and professionally with the Braves, uses two words to describe what makes the Cubs environment similar: “No egos.” “People care about other people more than themselves. In successful places, that’s what you need,” Swanson said. “The Vanderbilt football coach (Clark Lea) texted me, asking me the one thing that stands out from what I learned at Vandy. I sent him a couple of things. But one of ‘em was servant leadership. Do more for others than yourself. “If you think about the most impactful people in your life, they were the most giving, the most serving. If that was the most impactful person to you, then why wouldn’t you do the same?” In baseball, over the long haul of 162 games, the smallest of gestures can make a difference. Hitters sharing tips in the batting cage. Starting pitchers offering each other advice after watching their respective bullpen sessions. The Cubs are hardly the only team doing those types of things. But for this group to evolve into the Next Great Cubs Team, such building blocks are necessary. “It’s a huge part, especially with the ups and downs you go through,” said Napoli, the three-time World Series participant. “When people are struggling and you know someone has your back. … It’s always better hearing it from a teammate than a coach. It just comes different. The closer you are in that clubhouse, it just takes care of a lot of stuff.” The Cubs are taking care of it. Maybe it will amount to nothing. Maybe it will mean a lot.

[newss-24]

Dodgy lawyer Lesley Ramulifho still doing work for Lottery

Lawyer represented NLC in salaries dispute this year

Despite being under investigation for corruption involving multimillion-rand Lottery grants, lawyer Lesley Ramulifho has continued to supply legal services to the National Lotteries Commission (NLC).

This was revealed in an arbitration award by Commission for Conciliation, Mediation and Arbitration (CCMA) Commissioner Nathalie Willemse on 22 May.

The award states that Ramulifho Attorneys — Ramulifho’s law firm — represented the NLC in the matter and briefed an advocate to represent the NLC. Advocate Ben Ridgard, who represented the NLC in the arbitration matter, confirmed that Ramulifho’s law firm “was my instructing attorney”.

The award involved a long-running salary dispute between the NLC and two trade unions, the National Education, Health and Allied Workers’ Union (NEHAWU) and the National Union of Public Service and Allied Workers (NUPSAW). The dispute had dragged on since 2014 before being settled in favour of the unions’ members, after several hearings, the most recent of which was in April this year.

The NLC did not respond to emailed questions about Ramulifho’s work for the Commission. Ramulifho was emailed a copy of the same questions sent to the NLC, asking him for comment. He did not respond either.

There was also no response to an email sent for the attention of the NLC board via board member Willie Hofmeyr.

Organisations linked to Ramulifho and members of his staff employed in his Pretoria law practice have received at least R60 million in Lottery grants. Among these are an R27.5 million grant to Denzhe Primary Care, a hijacked nonprofit organisation, for a drug rehabilitation centre near Pretoria, where at least R20 million is unaccounted for.

Newss24 has reported how Ramulifho used the Denzhe grants as his personal ATM, and to help pay for a luxury home he bought for himself on a luxury Pretoria “country estate”. We have also reported how Ramulifho forged documents in an affidavit he filed in a case he launched against Newss24.

Responding to a parliamentary question in July 2020, NLC Commissioner Thabang Mampane said that neither Ramulifho nor his firm were on the NLC panel of approved attorneys.

Nevertheless, she confirmed that “Ramulifho Inc. has rendered legal services for labour-related issues to the then National Lotteries Board now the NLC. This was approximately around 2014, prior to the advent of the [NLC] panel of legal service providers.”

What Mampane didn’t disclose is that though neither Ramulifho nor his law firm were on the NLC’s panel of lawyers, Ramulifho had continued doing legal work for the NLC. (Lawyers must go through a tender process to get onto the panel.)

This was only revealed in a response almost 18 months later, in March 2021, by Mampane to another Parliamentary question, in which she confirmed that Ramulifho Inc Attorneys had been paid R5.4 million by the NLC for legal work between the 2016-17 and 2019-20 financial years.

[heatcharger]

Indian thermal power generator NLC launches 500 MW solar tender - pv magazine International

http://dlvr.it/SmLxJK

[hardynwa]

CBN to flood banks with old naira notes

The Central Bank of Nigeria has finally concluded plans to release all N1,000, N500 and N200 notes in its custody to Deposit Money Banks, The PUNCH can report authoritatively. This decision is expected to end months of hardships and pains Nigerians have been going through following a controversial CBN naira redesign policy that has caused a severe shortage of old and new naira notes across the country. The CBN’s latest decision came several weeks after the Supreme Court ordered that old N1,000, N500 and N200 notes should remain legal tender until December 31, 2023. On Wednesday night, top officials of the CBN and commercial banks confirmed to The PUNCH that the CBN Governor, Godwin Emefiele, had directed the DMBs to begin the disbursement of old N1,000, N500 and N200 notes to members of the public effective Thursday (today). According to him, the CBN will also start releasing old notes to commercial banks from Thursday. The PUNCH learnt Emefiele met with the chief executive officers of the DMBs on Wednesday evening where he told them that the central bank would start releasing all old notes in its custody to commercial banks effective Thursday (today). Sources at the meeting said the CBN would also be cancelling all the controversial cash withdrawal limits it put in place in recent months. Also, it was learnt the CBN would start by releasing crisp old notes to DMBS after which the ones deposited by commercial banks will also be released. Furthermore, the CBN stated at the meeting that bank customers would no longer be required to generate any code before depositing their old notes. One of the bank CEOs at the meeting, who spoke on condition of anonymity, said, “The CBN governor met with bank CEOs this evening virtually. It was a short meeting that lasted for just about 15 minutes. The governor said all old N1,000, N500 and N200 notes will be released to commercial banks beginning from Thursday. The CBN will start with crisp old notes after which the ones deposited by DMBs will be returned. The plan is to flood the economy with cash and ameliorate the challenges Nigerians have been passing through.“ Top bank chief The top bank chief added, “Also, the CBN will be cancelling cash withdrawal limits it put in place recently. This means that individuals can now withdraw up to N500,000 across the counter while corporate bodies can do N5m. The CBN is expected to release a circular to this effect later tonight or tomorrow morning (today). But effectively, things should be back to normal as far the cashless policy is concerned.” Further findings by The PUNCH confirmed the CBN would begin to release the old notes into circulation by Thursday. It was also gathered that banks would begin to pay their customers the old notes immediately to ensure the cash circulate across the country. According to reliable sources in the CBN, banks have been also been directed to report to the old offices to collect the old naira notes they deposited with the apex bank. They noted that before the end of the week, the country would be awash with naira notes. Meanwhile, a top source close to the CBN said the apex bank took the decision to avert the planned picketing of the CBN offices nationwide by supporters and leaders of the Nigeria Labour Congress. NLC protests Earlier, The PUNCH had gathered that the NLC would on Wednesday picket the CBN headquarters and state offices in protest against the lingering naira crisis and fuel scarcity in the country. The NLC President, Joe Ajaero, who disclosed this at a press conference on Wednesday, lamented that people’s hardships over the naira crisis had worsened. The union had penultimate Monday issued a seven-day ultimatum to the Federal Government to address the scarcity of naira notes and fuel which had compounded the hardships being faced by Nigerians. Though the CBN said then that it had complied with the Supreme Court judgment which directed that the old N200, N500 and N1000 notes should remain legal tender till December 31, banks have continued to ration the amount of cash issued to customers, indicating that they have not received cash supplies from the apex bank. The three states of Kaduna, Kogi and Zamfara which sued the Federal Government over the naira redesign policy had threatened to file contempt charges against the Attorney-General of the Federation, Abubakar Malami, SAN and the CBN governor, Emefiele for not fully complying with the Supreme Court judgment. Speaking at a press briefing in Abuja on Wednesday, Ajaero said the planned picketing of CBN offices became imperative following the apex bank’s failure to comply with the one-week ultimatum given to it to make cash available for Nigerians. Ajaero explained that the union took the decision when it noticed that the situation appeared to be getting worse despite the Supreme Court order allowing the old N500 and N1000 notes to circulate with the new notes till December 31. He directed all NLC’s affiliate unions and their state councils to begin mobilisation on Friday for the nationwide mass action, saying the Federal Government and the CBN have not shown any commitment to address the situation. Giving an update about the ultimatum at the briefing which was held at Labour House, Ajaero said workers could no longer access cash to pay fares to their respective workplaces or buy food for their families. He said, “Last week at the end of our CWC (Central Working Committee) meeting, we gave a one-week ultimatum for the Federal Government to address immediately, among other issues, the issue of cash crunch that was caused by the policy. As of this morning when the CWC met again to review the situation, we discovered that not much improvement has been made. “The situation is still almost the same. People are still buying our currency with our currencies. People no longer have access to the currency and the government seems to be very adamant about this. No moves have been made to reduce the suffering of Nigerians. Read the full article

[indiagovtjobsinfo]

PESB Released NLC Directors Recruitment 2018

#NlcFullForm, #NlcIndiaApprenticeship, #NlcIndiaRecruitment2017, #NlcJobs, #NlcRecruitment, #NlcRecruitment2018, #NlcRecruitmentForEngineers, #NlcSharePrice, #NlcTenders #Careers, #CentralGovtJobs, #Companies, #GovtJobsInIndia, #GovtJobsInStates, #JobNotifications, #Jobs, #JobsforEngineering, #Notifications, #OtherCentralGovtJobs, #PrivateSectorJobs, #PublicSectorJobs, #StateGovtJobs, #Technology Click Here For More Hot Images PESB Released NLC Directors Recruitment 2018 India Govt Jobs

[irvinenewshq]

This can be a tough time for me: Terry Pheto denies involvement in lotto fraud

Terry Pheto. @aust_malema/Terry Pheto Instagram Tsotsi lead actress Terry Pheto has denied her involvement within the lottery corruption scandal.  Pheto and eight others are accused of defrauding the Nationwide Lotteries Fee.  Pheto has denied any involvement and says she’s going to cooperate with investigations. Main actress within the Oscar-winning movie Tsotsi, Terry Pheto, has denied involvement within the alleged fraud regarding funding the Nationwide Lotteries Fee (NCL). On Friday, Metropolis Press reported that Pheto was amongst eight folks, together with two legal professionals, an accountant, a resort group chief govt officer (CEO) and a former commissioner of the NLC, to be investigated by Particular Investigations Unit (SIU) in a multimillion-rand fraud scheme. “This fraud scheme allegedly noticed them acquiring properties via cash fraudulently acquired from the NLC,” the report stated. Based on Metropolis Press, the SIU was granted an order by the excessive courtroom in Pretoria to grab 9 luxurious properties in Pretoria, Centurion, Hartbeespoort, and Johannesburg, pending the ultimate willpower of the appliance for remaining forfeiture. In an announcement on Saturday, Pheto stated she was dismayed to find that she was the topic of a SIU probe into allegations of fraud regarding funding by the NCL. READ | Tender tycoon with ties to Ramaphosa household raked in virtually R400m from Gauteng hospitals – MEC “I deny any involvement within the alleged scheme that has been reported on. I additionally had no prior data of an utility to acquire a preservation order in opposition to me and haven’t any sight of this order,” she stated. Pheto stated she holds the legislation in excessive regard and would cooperate totally with the investigation overtly and transparently. She has described this ordeal to be a tough time for her.  “This can be a tough time for me. I wish to thank everybody for his or her unwavering messages of help.” Originally published at Irvine News HQ

[indiafrontline123]

NLCIL Floats Global Tender Enquiry by EIL for Gasification Block

In the august presence of DR. Anil Kumar Jain, Secretary, MoC, Shri Amrit Lal Meena, Officer on Special Duty, MoC, Shri Rakesh Kumar, CMD, NLCIL, and Smt. Vartika Shukla, CMD, EIL, NLC India Limited launches a global tender inquiry through Engineers India Limited for the gasification block (LEPC-1) of the Lignite to Methanol project at Neyveli.

[indiaenergystoragealliance]

Large Scale Energy Storage Market in India Witnessing a Jumpstart: SECI and Neyveli Lignite Corporation tenders create a buzz

Last time this year, over thirty renewable energy and energy storage companies in the Indian market were busy applying for the MNRE (Ministry of New and Renewable Energy) Expression of Interest for RE integration with energy storage. 

However, the excitement soon died down with the delay of the announcement of the results, which are still expected. The lull continued with SECI’s (Solar Energy Corporation of India) tenders getting delayed and the only other notable announcement being made by the GIFT City for a consulting tender for designing of a battery energy storage tender for India’s first financial SEZ project in Gandhinagar, the capital city of Gujarat.

However, the second half of the year is finally allowing energy storage manufacturers, project developers, and IPPs in the Indian market to witness the end of this perpetual wait. With over 37 MW of energy storage projects announced/tendered by SECI and NLC (Formerly Neyveli Lignite Corporation), the market is gearing up. These projects will come up in different parts of the country, namely Himachal Pradesh, Andhra Pradesh, Karnataka, and Andaman Islands. 

 Among the contracted, there are 3 MW pilot projects for frequency regulation applications by PGCIL (Power Grid Corporation of India) in Puducherry. The PGCIL projects are likely to enter the installation and commissioning phase in a later part of the year.

Apart from these activities, prominent players in the market like AES and Panasonic have declared their own 10 MW Li ion-based collaborative ESS project at the Panasonic white goods factory in Jhajjar, Haryana.

These projects together will be worth close to $20 million for the energy storage industry and will put India on the megawatt scale storage projects map with 50 MW and 33.5 MWh in contractual, tendering, and announcement phases. The announcements lined up for October may be even bigger; especially the NTPC solar PV and energy storage project in Andaman and Nicobar is likely to ask the bidders to submit their bids for 7 MW:42MWh of energy storage. 

This is a huge opportunity for the global energy storage community and some good news for the Indian electricity market, which is still awaiting the installation of its first-megawatt scale battery energy storage project. In this respect, the Indian grid-scale storage market is lagging behind countries like the US, China, South Korea, and Japan.

But whether this year can make a change is literally a million-dollar question.

These crusades in the market have created a buzz among Indian conglomerates and they are now more likely to invest in Li-ion cell manufacturing with over 15 GW of large-scale opportunities likely to line up in the next seven years. 

Apart from these, many international battery companies - especially flow battery companies - are lining up in the market with more and more island projects likely to be announced. They are also keeping a close eye on spurting rural microgrids and solar roof-top markets.

The last thing the market would like to witness is under-prepared tendering and further delays in the closing of the tenders. 

Many project developers have also asked India Energy Storage Alliance for clarity in testing validation and certificate requirement for both the components used and about the total integrated solar plus storage system. 

Third-party testing agencies like UL and CSA have taken a long shot at the market and are likely to help other stakeholders. It is evident that the energy storage business value chain and support system is yet to establish itself. However, with these projects lined up, it is high time that the industry strengthens its services and offerings in the Indian market.

On an optimistic note, with the falling prices of Li-ion chemistry as many players quote close to $370 per kWh, growth prospects are looking unquestionably brighter. 

Can energy storage tell a better growth story than LED or solar PV? We certainly hope so, and sustain it all the way!

 You can learn more by becoming an IESA member.

[bigmacdaddio]

Through his love of baseball Tim McCarver reached the top of two professions.

McCarver was a standout linebacker in high school so skilled and fierce that Notre Dame recruited him. After his senior year he instead signed with the St. Louis Cardinals, beginning a professional baseball playing career that lasted more than 20 years.McCarver’s first pro game featured future announcer Brent Musberger as the umpire calling balls and strikes. No one could have predicted that both men would later earn Sports Emmy Awards and the Vin Scully Lifetime Achievement Award in Sports Broadcasting.A native of Memphis, Tennessee, McCarver played his first big league game in 1959 at the tender age of 17. He became the Cardinals starting catcher in 1963, and hit .289.The following season McCarver helped St. Louis win the pennant.

The Cardinals capitalized on an epic collapse by Gene Mauch’s Phillies and held off the Reds to earn the World Series berth.In the Fall Classic McCarver went 11-for-23 with a double, triple, home run, five walks, five runs batted in and four runs scored. The St. Louis catcher recorded a hit in all 7 games. The 23-year old’s gaudy .478 batting average and .552 on-base percentage complimented the pitching performance of Series MVP Bob Gibson to push the Cardinals over the top.McCarver was named to his first All Star team in 1966. In that contest he scored the winning run in the National League’s victory. That season he became the first catcher to lead the NL in triples.In 1967 McCarver had his finest season. In the second of consecutive All Star campaigns, he posted career highs in homers and RBI. The backstop finished the year with an OPS+ of 136. His performance earned him a second-place finish to Orlando Cepeda in MVP balloting.McCarver and the Cardinals reached the Fall Classic again in 1967 and ’68. The ’67 tilt was a 7-game thriller won by St. Louis over the Impossible Dream Boston Red Sox. In ’68, the Tigers vanquished the Cardinals.McCarver reached the postseason three more times with the Phillies back-to-back-to-back trips to the NLCS starting in 1976.

When McCarver retired as a player in 1980 he had 21 big league seasons to his credit. The two-time All Star finished with 1,501 hits, and a pair each of All Star and World Series rings. He caught 121 shutouts and is the first 20th-century catcher to appear in four different decades.After the 1979 season McCarver moved to the Phillies broadcast booth. His work was briefly interrupted with a 6-game comeback as a player in 1980. After four years in Philadelphia, McCarver was hired by the Mets. When ABC fired Howard Cosell just before the 1985 World Series, McCarver announced his first Fall Classic.McCarver remained with the Mets until 1998 before moving on to the Yankees for three seasons starting in 1999. He also spent one year calling Giants games in San Francisco. Later his weekly syndicated interview show drew more than 90 million viewers. Though his playing career lasted 21 seasons, his broadcast career was even more prolific.During his career behind the mic, McCarver earned six Emmys. He was given the profession’s highest honor when he received the Hall of Fame’s Ford C. Frick Award in 2012.Through his love of baseball, Tim McCarver reached the pinnacle of two professions.

[gigspk]

GM Procurement HQ NLC Rawalpindi 2021 Tender Notice #gigspk #careers #Job #Pakistan #jobsearch #jobseekers #jobupdates #latestjobs #jobsalerts Latest, Today, Fresh, New & Upcoming Jobs 2021 of all Govt & Pvt. Pakistani Newspaper & Admissions Tenders. Pak Army, Judiciary, Patwari, Revenue, WAPDA, NADRA, FPSC, PPSC, NTS, OTS, CTSPAK & More Jobs + How to apply for a job with complete details. https://www.gigspk.com/gm-procurement-hq-nlc-rawalpindi-2021-tender-notice/?feed_id=86488&_unique_id=615966bfda773

[gospelmusic]

 Health Workers Give El-Rufai 48 Hours To Recall Sacked Nurses

Governor Nasir El-Rufai of Kaduna state has been given 48 hours to reinstate sacked nurses.

 The ultimatum was given by the Medical and Health Workers’ Union of Nigeria (MHWUN).

The governor has also been asked to tender a public apology to the Nigerain workers.

 Recall that the Governor had sacked nurses who are below level. 14 for joining the protest by NLC in the state.

 MHWUN, in a statement by its President, Biobelemoye Joy Josiah, described the actions of the governor as “barbaric, primitive and anarchist” that is still being practised in modern day Nigeria.

 Josiah explained that the governor had earlier “illegally and forcefully” retired officers who are 50 years of age and above, officers on GL. 14 and above, converted officers on GL. 01 – 06 to casual labourers and dismissed nurses on GL. 14 and below.

 These actions, according to him, were taken without regard to extant labour laws and circulars that regulate employment of public servants whose appointments are clothed with statutory flavour.

[3sportsguns]

Cubs are a $inking $hip

The direction of the Chicago Cubs was already in question when Yu Darvish was shipped to San Diego for no top end prospects and none of them pitching. If you aren't a Cubs fan the one area they've struggled with is pitching, with the brain trust never able to develop a starter. With Jed Hoyer at the lead of the front office it makes no sense to see the team purge pitching.

The Darvish trade was already a head scratcher and that was followed up with Jose Quintana going to the Angels and Jon Lester signing a five million dollar deal with the Nationals. Lester strongly implied he wanted to retire a Cub and instead signed for peanuts in the National League. It's an embarrassment for the team to treat the guy that was a pillar in changing the Cubs in to regular contenders that way.

Pitching was a big need for the team but the offense was far from set with Chicago having 'stars' that were under performing. Hence, Cubs fans find themselves in an off season where Kris Bryant, Wilson Contreras and Javier Baez are all on the trade block, and that's after Kyle Schwarber and Albert Almora non-tendered. Young catcher Victor Caritini was also sent to the Padres as Darvish's personal catcher.

The Cubs haven't vocally established their direction. If you squint you could maybe say it's a rebuild but if more trades look like the Darvish one then it's going to be a rough one, and there's no damn way they can say they're competing. This has owner Tom Rickett's fingerprints all over it as Chicago just looks like they want to dump money.

Chicago Cub fans heard more than their fair share of jokes about the long World Series drought before arriving at the top of the MLB starting with the 2015 NLCS sweep against the New York Mets. Finally fans saw a World Series win and it looked like the start of a dominant run for a very young team and instead five years later management, and especially ownership, has quickly run this team back to those teams of laughingstock status.

I would take it a step further, the Chicago Cubs are an embarrassment. They are part of a bigger MLB problem with the cheapness for major markets across the board, but the Cubs are a crown jewel franchise and are acting like the Tampa Bay Rays. The direction, if there really is one, is to go on the cheap while probably gouging fans who decide to get suckered in to traveling to Wrigley Field.

If you're a Chicago fan then franchise ineptitude is nothing new for your fandom. In fact, Chicago franchise history is tantalizing fans with teams that look to be on long runs only to fall flat in rapid decline. The Cubs were swept back-to-back times in 07 and 08, the 1985 Bears were one of the youngest teams in the NFL on their dominant Super Bowl run and flamed out, Jerry Krause forced out everyone part of the second three-peat during the third championship run, Derrick Rose's knees tanked the Bulls team that challenged the Heat's big three. The Blackhawks won the two Stanley Cups in three years and then went out in back-to-back first rounds before hitting the tank. The Bears won the division two seasons ago and then missed the playoffs and backed in this season, where they didn't deserve to be.

Don't get me wrong, there are way worse cities to be fans in but is it really better to have and lost than to not have at all? Chicago gets to the pinnacle and then finds a way to quickly fall back in to a middling franchise. For one of the most historic cities in all the sports leagues to regularly be this bad is what Chicago fans have to deal with and the Cubs are just continuing their normal historic trend, as an embarrassment.

[emunenen]

Makao Bora

New Post has been published on https://wp.me/paK8na-456

KCB joins the court battle to save DP Ruto's Weston Hotel from demolition

KCB Group has backed the court battle to block repossession of land on which Weston Hotel sits, fearing loss of security to the Sh1.2 billion loan it advanced the business associated with Deputy President William Ruto five years ago.

The bank Thursday told Justice Benard Eboso that the Kenya Civil Aviation Authority (KCAA) erred in filing a fresh suit for repossession of the land instead of challenging a 2019 decision of the National Land Commission (NLC).

The NLC had directed that Weston Hotel keeps ownership of the land and pays off KCAA for the property at the current market value.

But KCAA is pushing for revocation of the title issued in the 1990s, which ultimately will lead to the demolition of the hotel, drawing protests from the Deputy President.

KCB, which offered Weston Sh1.2 billion five years ago, has asked justice Eboso to dismiss KCAA and offered support to the hotel.

“We now tender these submissions to support the 2nd respondent (Weston Hotel) application,” said KCB in a court affidavit.

    KCB says the law provides a procedure for an appeal before the Environment and Land Court, adding that KCAA should have appealed against the land commission within 14 days instead of filing a fresh suit.

“The petitioner had the option of appealing the determination of NLC within the prescribed period if it was aggrieved. It did not. In bad faith and without regard to due process, it filed the instant petition in a guise that its constitutional rights had been violated,” the bank said.

“We humbly ask your lordship not to sanction such an abuse of court process.”

KCAA wants the decision by NLC directing the management of the hotel to compensate the agency for the land quashed.

Weston has maintained that it was an innocent purchaser and that the case was filed with ulterior motives, especially after NLC made a finding that the title was acquired legally.

Last year, the court stopped the implementation of NLC’s decision.

The disputed public land had been acquired by the defunct Directorate of Civil Aviation in the early 1990s for the construction of its headquarters.

The agency stated that Weston embarked on rapid construction without obtaining mandatory development approvals from relevant State regulatory agencies.

    KCB waded into the dispute, arguing that it did due diligence and confirmed that Weston was the registered proprietor of the land before advancing more than Sh1.2 billion to the hotel five years ago.

Cancelling the title as pleaded by KCAA, said the lender, would prejudice it as it would end up losing monies, which the hotel was still repaying.

The lender said the first loan of Sh350 million and $1,500,000 (Sh167.4 million) was advanced to the hotel in October 2014 and charge registered.

The bank said about a year later, in July 2015, the hotel took a further loan of Sh700 million and charged the property.

“At the time of registration, the interested party (KCB) did a due diligence and fulfilled all prerequisites to registration of the charge in land as required by law,” the bank said in documents filed in court.

KCB is fretful that an order declaring the title illegal would prejudice it, arguing it would lose the only security it attached to the loan.

Dr Ruto has linked the court bid to demolish Weston to the politics around the 2022 presidential election where he is fighting to replace President Uhuru Kenyatta.

        Read the whole story on BD Africa

[hardynwa]

Naira scarcity: NLC insists on seven-day ultimatum to CBN, Banks ration old notes

Deposit Money Banks have begun to ration the disbursements of old N1,000 and N500 notes to their customers amid uncertainty over whether the Central Bank of Nigeria will release the old notes in its custody. This came about 24 hours after the CBN Governor, Godwin Emefiele, announced that old N1,000, N500 and N200 notes remained legal tender. But despite the CBN’s statement on Monday night, the Nigeria Labour Congress on Tuesday insisted on the seven-day ultimatum it gave the Federal Government to end the cash crunch. The apex bank’s position came on the heels of several weeks of confusion over the legal status of the old currencies amid a series of Supreme Court judgments in a suit between some state governments and the Federal Government. The declaration by the CBN was expected to put an end to the scarcity of old and new naira notes that had inflicted pain on Nigerians but findings by The PUNCH on Tuesday revealed that the naira crisis might not be over soon. Investigations by our correspondents revealed that banks were rationing old notes to their customers via over-the-counter payments with a few lenders loading their Automated Teller Machines. But The PUNCH findings revealed that the majority of the lenders in Lagos, Abuja, Ogun, Kwara and other states were paying only N5,000 to each customer over the counters, while a few banks paid N10,000 only. Further findings indicated that only a few banks loaded their ATMs and most of them were disbursing only N5,000. Top bank executives revealed that most banks were paying what was left in their vaults, having sent a major chunk of old naira deposits to the CBN several weeks ago. Other officials said lenders were also paying customers from little fresh deposits made by their customers. Lagos banks Due to the naira scarcity, Wema Bank at Ilupeju, Lagos placed a limit on its ATM withdrawals from other banks’ cards and was dispensing only old naira notes. When The PUNCH visited the branch, the bank’s customers were able to withdraw only N10,000 with Wema Bank’s cards, while other banks’ customers could withdraw only N4,000 only. At the Access Bank branch on CMD Ikosi Road, Lagos, customers were asked to generate a code from the CBN portal before they could be allowed to deposit. They said this was mandatory although the CBN had declared old notes legal tender. One of the bank officials who attended to our correspondent said, “We are paying the old notes but if you want to deposit them, you must go and generate the pin from the CBN portal.” A visit to the First Bank branch at Mazamaza along Lagos-Badagry Expressway revealed that the bank had started dispensing the old notes via over-the-counter withdrawals. At the Union Bank branch also in Mazamaza, the situation was the same. The branches of United Bank for Africa, Access Bank, and Fidelity Bank at Oshodi in Lagos also dispensed old notes to their customers, though they had long queues. At the Fidelity Bank branch, one of their three Automated Teller Machines was dispensing old N1,000 notes. A customer, who collected the old notes from the ATM, Helen Orji, expressed relief. She said this was the first time that she was able to collect cash from an ATM. “It’s a major relief. PoS charges are killing. I wanted to buy baby formula on Monday, so I went to collect N5,000 and was given N4,000. It wasn’t enough for what I wanted to buy. To be able to go back to normal is a relief.” Meanwhile, when a bus conductor plying the Mile 2-Oshodi route on Tuesday attempted to refuse the old notes, his passengers revolted and started handing him old N500 and N1,000 notes. He backed down and accepted the old notes. Old notes A businesswoman, Omolayo Shittu, who went to buy fabrics at Oshodi on Tuesday told our correspondent that traders had started accepting the old notes. Read the full article

[pullen-kharan-news]

(پھلین خاران نیوز)

پاک فوج کے کمرشل کاروباری ادارے جوملک کی کم و بیش %60 معیشت میں حصہ دار ہے، اس سلطنت کے 4 حصے ہیں . اور انکم ٹیکس،سیلز ٹیکس سے مثتثا ہیں ۔

01۔ آرمی ویلفیئر ٹرسٹ

02۔ فوجی فائونڈیشن

03۔ شاہین فائونڈیشن

04۔ ��حریہ فائونڈیشن

فوج ان 4 ناموں سے کاروبار کر رہی ہے۔ یہ سارا کاروبار وزارت دفاع کے ماتحت کیا جاتا ہے۔ اس کاروبار کو مزید 3 حصوں میں تقسیم کیا گیا ہے.

نیشنل لاجسٹک سیل NLC ٹرانسپورٹ

یہ ملک کی سب سے بڑی ٹرانسپورٹ کمپنی ہے۔ جس کا 1،698 سے زائد گاڑیوں کا کارواں ہے اس میں کل 7،279 افراد کام کرتے ہیں جس میں سے 2،549 حاضر سروس فوجی ہیں اور باقی ریٹائرڈ فوجی ہیں۔

فرنٹیئر ورکس آرگنائیزیشن (FWO):

ملک کا سب سے بڑا ٹھیکیدار ادارہ ہے اور اس وقت حکومت کے سارے اہم Constructional Tenders جیسے روڈ وغیرہ ان کے حوالے ہیں اس کے ساتھ ساتھ کئی شاہراہوں پر ٹول ٹیکس لینے کے لیے بھی اس ادارے کو رکھا گیا ہے۔

ایس سی او SCO:

اس ادارے کو پاکستان کے جموں کشمیر، فاٹا اور Northern Areas میں کمیونیکیشن کا کام سونپا گیا ہے۔

مشرف سرکار نے ریٹائرمنٹ کے بعد (4-5) ہزار افسروں کو مختلف اداروں میں اہم عہدوں پر فائز کیا ہے اور ایک رپورٹ کے مطابق اس وقت ملک میں 56 ہزار سول عہدوں پر فوجی افسر متعین ہیں جن میں 1،600 کارپوریشنز میں ہیں۔

پاکستان رینجرز بھی اسی طرح کاروبار میں بڑھ کر حصہ لے رہی ہے جس میں سمندری علائقے کی 1،800 کلومیٹر لمبی سندھ اور بلوچستان کے ساحل پر موجود جھیلوں پر رسائ ہے۔ اس وقت سندھ کی 20 جھیلوں پر رینجرز کی عملداری ہے۔ اس ادارے کے پاس پیٹرول پمپس اور اہم ہوٹلز بھی ہیں۔

اہم بات یہ ہے کہ FWO کو شاہراہوں پر بل بورڈ لگانے کے بھی پیسے وصول کرنے کا حق حاصل ہے۔

15 فروری 2005 میں سینیٹ میں ایک رپورٹ پیش کی گئی تھی۔ جس کے مطابق فوج کے کئی ادارے اسٹاک ایکسچینج میں رجسٹرڈ بھی نہیں ہیں اور ان کی یہ سرمایہ کاری کسی بھی صورت میں عالمی سرمایہ کاری سے الگ بھی نہیں ہے۔ مندرجہ زیل لسٹ سے یہ اندازہ لگایا جا سکتا ہے کہ افواج پاکستان کیسے اس سرمایہ کاری میں مصروف ہیں۔

آرمی ویلفیئر ٹرسٹ کے پروجکٹس:

01۔ آرمی ویلفیئر نظام پور سیمنٹ پروجیکٹ

02۔ آرمی ويلفيئر فارماسيوٹيکل

03۔ عسکری سيمينٹ لمٹيڈ

04۔ عسکری کمرشل بينک

05۔ عسکری جنرل انشورنس کمپنی لمٹيڈ

06۔ عسکری ليزنگ لميٹيڈ

07۔ عسکری لبريکينٹس لميٹڈ

08۔ آرمی شوگر ملز بدين

09۔ آرمی ويلفيئر شو پروجيکٹ

10۔ آرمی ويلفيئر وولن ملز لاهور

11۔ آرمی ويلفيئر هوزری پروجيکٹ

12۔ آرمی ويلفيئير رائس لاهور

13۔ آرمی اسٹينڈ فارم پروبائباد

14۔ آرمی اسٹينڈ فارم بائل گنج

15۔ آرمی فارم رکبائکنت��

16۔ آرمی فارم کھوسکی بدين

17۔ رئيل اسٹيٹ لاهور

18۔ رئيل اسٹيٹ روالپنڈی

19۔ رئيل اسٹيٹ کراچی

20۔ رئيل اسٹيٹ پشاور

21۔ آرمی ويلفير ٹرسٹ پلازه راولپنڈی

22۔ الغازی ٹريولز

23۔ سروسز ٹريولز راولپنڈی

24۔ ليزن آفس کراچی

25۔ ليزن آفس لاهور

26۔ آرمی ويلفيئر ٹرسٹ کمرشل مارکیٹ پروجيکٹ

27۔ عسکری انفارميشن سروس

فوجی فائونڈيشن کے پروجيکٹس:

01۔ فوجی شوگر ملز ٹنڈو محمد خان

02۔ فوجی شوگر ملز بدين

03۔ فوجی شوگر ملز سانگلاہل

04۔ فوجی شوگر ملز کين اينڈيس فارم

05۔ فوجی سيريلز

06۔ فوجی کارن فليکس

07۔ فوجی پولی پروپائلين پروڈکٹس

08۔ فائونڈيشن گیس کمپنی

09۔ فوجی فرٹیلائيزر کمپنی صادق آباد ڈهرکی

10۔ فوجی فرٹیلائيزر انسٹیٹیوٹ

11۔ نيشنل آئڈنٹٹی کارڈ پروجيکٹ

12۔ فائونڈيشن ميڈيک کالج

13۔ فوجی کبير والا پاور کمپنی

14۔ فوجی گارڈن فرٹیلائيزر گھگھر پھاٹک کراچی

15۔ فوجی سيکيورٹی کمپنی لميٹڈ

شاہين فائونڈيشن کے پروجيکٹ��:

01۔ شاہين انٹرنيشنل

02۔ شاہين کارگو

03۔ شاہين ايئرپورٹ سروسز

04۔ شاہين ايئرویز

05۔ شاہين کامپليکس

06۔ شاہين پی ٹی وی

07۔ شاہين انفارميشن اور ٹيکنالوجی سسٹم

بحريه فائونڈيشن کے پروجيکٹس:

01۔ بحريه يونيورسٹی

02۔ فلاحی ٹريڈنگ ايجنسی

03۔ بحريه ٹريول ايجنسی

04۔ بحريه کنسٹرکشن

05۔ بحريه پينٹس

06۔ بحريه ڈيپ سی فشنگ

07۔ بحريه کامپليکس

08۔ بحريه ہاوسنگ

09۔ بحريه ڈريجنگ

10۔ بحريه بيکری

11۔ بحريه شپنگ

12۔ بحريه کوسٹل سروس

13۔ بحريه کيٹرنگ اينڈ ڈيکوريشن سروس

14۔ بحريه فارمنگ

15۔ بحريه هولڈنگ

16۔ بحريه شپ بريکنگ

17۔ بحريه هاربر سروسز

18۔ بحريه ڈائيونگ اينڈ سالويج انٹرنيشنل

19۔ بحريه فائونڈيشن کالج بہاولپور

ملک کے تمام بڑے شہروں میں موجود کینٹونمنٹ ایریاز, ڈیفینس ہاوسنگ سوسائیٹیز, عسکری ہاوسنگ پراجیکٹس اور زرعی اراضی اوپر دی گئی لسٹ کے علاوہ ہیں۔

ہم میں سے یہ حقیقت کسی کو معلُوم نہیں کہ فوج کے تحت چلنے والے کاروباری ادارے خسارے, کرپشن اور بدانتظامی میں سٹیل مل اور پی آئی اے سمیت کسی سرکاری ادارے سے پیچھے نہیں۔

اِن کا خسارہ کم دکھانے کا طریقہ اندرونِ مُلک اور بیرونِ مُلک سے لیے ہُوئے قرضوں کو ایکُوئیٹی دکھا کر بیلینس شیٹ بہتر دکھانے کا ہے۔ لیکن اس کے باوجود یہ آج کی تاریخ میں بھی خسارے میں ہیں۔

یہ ایک ٹرینڈ ہے جو پچھلے 30 سال میں بار بار ریپیٹ ہوتا ہے اور ہر آڈٹ سے پہلے گورنمنٹ سے بیل آؤٹ پیکج نہ لیا جائے یا اندرونی و بیرونی قرضے نہ ہوں تو خسارہ ہر سال اربوں تک پہنچا کرے۔ لیکِن ہر گورنمنٹ خُود ان کو بیل آؤٹ پیکج دینے پر مجبور پاتی ہے اور جو دینے ��یں تامل کرے تو حکُومت گرنے کے اسباب ایسے پیدا ہوتے ہیں، جیسے بارش سے پہلے بادل آتے ہیں۔

[ourhaileydavies]

Attention to C-Spine in Craniofacial Trauma-An Update-Juniper publishers

Abstract

The evolution of research and techniques in management of a trauma patient has reduced the mortality rate significantly in the golden hour. Severe maxillofacial and neck trauma exposes patients to life threatening complications such as airway compromise and hemorrhagic shock. These conditions require rapid actions (diagnosis and management) and a strong interplay between first level health care providers, surgeons and anesthesiologists. The cases with pan facial trauma need at most scrutiny due to proximity to cranial and cervical structures. In this article an insight into the C-spine injuries in a pan facial trauma patient has been discussed.

Keywords: C-spine injury; Craniofacial trauma

Introduction

Maxillofacial injuries are frequent cause of presentations in an emergency department. Varying from simple, common nasal fractures to gross combination of the face, management of such injuries can be extremely challenging. Injuries of this highly vascular zone are complicated by the presence of upper airway and proximity with the cranial and cervical structures that may be concomitantly involved. The usual techniques of airway breathing and circulation (ABC) management are often modified or supplemented with other methods in case of maxillofacial injuries [1]. Polytrauma patient admitted to hospital may have injury to cervical spine which is not immediately obvious. Because patient is neurological normal, with no neck pain or patient is having distracting pain or patient is unconscious. In case where there is no clear indication of cervical spine injury, however, patients still needs to be evaluated for cervical spine injuries because an unstable cervical spine injury could to delayed & result in neurological deterioration. Cervical spine injuries have been reported to occur in up to 3% of patients with major trauma and up to 10% of patients with serious head injury [2].

Neck Anatomy

It is useful to divide the anatomical structures of the neck into five major functional groups, to facilitate and ensure a comprehensive assessment and surgical approach:

Airway - pharynx, larynx, trachea, lung.

Major blood vessels-carotid artery, innominate artery, aortic arch, jugular vein, subclavian vein.

Gastrointestinal tract-pharynx, esophagus.

Nerves - spinal cord, brachial plexus, cranial nerves, peripheral nerves.

Bones-mandibular angles, styloid processes, cervical spine.

The platysma defines the border between the superficial and the deep structures of the neck. If a wound does not penetrate deep to the platysma, it is not classified as a significant penetrating neck wound. As transverse cervical veins running superficial to the platysma may bleed profusely when severed, they are easily controlled by direct pressure, and can be managed by a simple ligature. The sternocleidomastoid muscle divides the neck into the posterior triangle which contains the spine and muscles, and the anterior triangle which contains the vasculature, nerves, airway, esophagus and salivary glands [3].

When evaluating penetrating neck injuries, the neck is divided into three anatomic zones for purposes of initial assessment and management planning:

Zone I: Extends between the clavicle/suprasternal notch and the cricoid cartilage (including the thoracic inlet).Surgical access to this zone may require thoracotomy or sternotomy. Major arteries and veins, trachea and nerves, esophagus, lower thyroid and parathyroid glands and thymus are in this zone.

Zone II: Lies between horizontal lines drawn at the level of the cricoid cartilage and the angle of the mandible. It contains the internal and external carotid arteries, jugular veins, pharynx, larynx, esophagus, recurrent laryngeal nerves, spinal cord, trachea, upper thyroid and parathyroid glands.

Zone III: Extends between the angle of the mandible and base of skull. It contains the extracranial carotid and vertebral arteries, jugular veins, cranial nerves IX–XII and sympathetic nerve trunk [4].

Cervical Spine and Maxillofacial Trauma

In a complex maxillofacial trauma scenario, cervical spine fracture should always be considered unless proven otherwise. Because of the proximity of cervical spine any force of such magnitude that causes facial fractures can potentially traumatize the c-spine and its ligamentous attachments [5].

Clinical awareness about the status of cervical spine is achieved using the most commonly used three evidence-based decision protocols, Nexus criteria [6], Canadian spine rule [7], Harbor view criteria [8]. In patients who are awake, clearance protocol can be effectively implemented by a detailed clinical examination; however, in an unconscious patient, it is not possible. The clearance of such patients hinges on clinical examination, risk, and radiographic examination such as noncontract computerized tomography, static flexon extension radiography, magnetic resonance imaging, and dynamic fluoroscopy [1,9].

Anderson et al. [10] reviewed cervical spine clearance in blunt trauma patients and classified patients based on their symptoms and ability to provide a reliable evaluation. Patients are acutely categorized into one of four groups

a) Asymptomatic: There are two main protocols for cervical clearance in the asymptomatic patient that have been and continue to be widely utilized:

i. National Emergency X-Radiography Utilization Study (NEXUS) Low-Risk Criteria (NLC) [6] and

ii. Canadian Cervical-Spine Rule (CCR) [7,11].

b) Temporarily non-assessable: Temporarily non assessable patients have a transient inability to provide a reliable examination. These patients are expected to resume their baseline cognitive function and be evaluable within 24-48 hours. Harris et al. [11] reported on this group of patients and found that most common factors in the category of temporarily non assessable are drug/alcohol intoxication, concussion, or pain from distracting injuries. Once the patient has regained adequate cognitive function and is deemed clinically asymptomatic after a comprehensive examination, he or she can be treated as such and cleared clinically without imaging. If a patient is presumed to regain his or her normal baseline cognitive function within the 24-48 hours time but cervical clearance becomes more urgent, such as when surgical intervention is required for other injuries, the individual can be evaluated as an obtunded patient with advanced imaging. The most common guideline for this patient population is to have them undergo a multi-detector CT scan and/or maintain their cervical collar [11].

c) Symptomatic: Symptomatic patients are those with neck pain, tenderness, or neurologic symptoms. This subgroup requires spinal imaging. The various imaging options include static and dynamic plain radiographs, CT, and MRI. Each of these various imaging methodologies has specific advantages and disadvantages, not only regarding sensitivity and specificity but also in terms of timing and cost. Plain radiography is one of the earliest imaging modalities and is currently readily available, fast, and low cost in comparison to other types of studies. In patients with suspected spine trauma, plain radiographic evaluation has been shown to have a wide range of reported sensitivity for cervical spine injuries ranging from 31.6 to 52% depending on the study [11,12].

d) Obtunded: Cervical spine clearance in the obtunded patient is the most controversial aspect and focuses mainly on whether an MRI is necessary in addition to a negative MDCT. Though an exceedingly rare incident, isolated neurologic injury does occur and can lead to significant morbidity. The percentage of acute trauma patients who are obtunded at the time of evaluation ranges from about 20 to 30% [3,11,13].

Diagnostic Imaging

Plain radiography

The lateral view is 83% sensitive and 97% specific for detecting cervical spine fracture. Adding an open mouth view and AP view increases sensitivity to nearly 100%. The open mouth view is essential for excluding C1 arch or C2 odontoid process fractures. The AP view assesses alignment of uncovertebral joints and spinous processes. Oblique views can be used to assess facet joints, pedicles, and lateral mass, especially at the cervicothoracic junction. If the cervico-thoracic junction cannot be visualized on the lateral view, obtain a swimmer’s lateral view or a CT scan.

Obtain a CT scan if the patient has normal x-rays but persistent cervical tenderness and pain. Flexion extension views are not useful in the acute setting. Pain and discomfort preclude adequate motion to assess for ligamentous injuries. Only perform a flexion-extension view on an alert patient under supervision. Flexion with an occult ligamentous injury may precipitate neurologic injury [2,14,15].

CT scan

A CT scan is useful for determining the presence and extent of osseous injury. In fact, it is superior to MRI in this situation. In blunt trauma patients, CT scan detects 99.3% of cervical spine fractures. Injuries in the transverse plane may be missed on axial cuts, i.e., odontoid fractures. It is essential to obtain coronal and sagittal reconstructions [2,16].

MRI

MRI is indicated for evaluating neurologic deficits and ligamentous injuries.MRI is superior to CT for demonstrating spinal cord pathology, intervertebral disc herniation, and ligamentous disruption. MRI has limited usefulness as the primary means for initial cervical clearance. The highly sensitive images of MRI show muscular and soft tissue images that do not necessarily correlate with clinical instability. MRI is not necessary if the initial screening CT is negative and the patient does not demonstrate neurologic abnormalities. CT has evolved to be first line modality in obtunded patient in a trauma setting. If the CT is negative, Anderson supports discontinuing the cervical collar. MRI may find abnormalities even if the CT is negative; however, these abnormalities are not likely to be clinically significant. The American College of Radiology advocates both CT and MRI for clearance of the obtunded patient [2,17,18] (Figure 1).

Conclusion

There is a continuing debate about the credibility of these clinical protocols in C-spine without the aid of radiographic assessment. In a neurologically unstable patient, the cervical spine must be immobilized irrespective of the injury. The universally accepted method of C-spine management includes hard collars, block and straps, and manual axial inline stabilization. These management methods are rather emotional and lack adequate scientific basis, especially in conscious patients. However, the generally accepted fact is that the application of collar protects and stabilizes the cervical spine temporarily until definitive management is done. The cervical collar should be applied by an experienced person or a person trained to do that. It should be snugly fitted to aid immobilization and while applying care should be taken not to compress the neck. Improper applications of collars are implicated in airway obstruction and perhaps rise in intracranial pressure by affecting the venous return from the brain. This complicates head injury and increases the cerebrospinal fluid leakage form skull base fractures and creates problems during operative repair of maxillofacial injuries. The gravity of all maxillofacial injuries lies in the fact that they pose an immediate threat to life because of its proximity to both the airway and brain. All the same, each case is unique; thus, the management is exacting even for the most experienced of professionals. In any given scenario, no treatment approach can be sure and flawless. The need of the hour is a multipronged approach requiring a partnership between several departments. While new technology and material developments [19] have helped ease the situation, it is the timely intervention, she

er skill, and presence of mind of emergency personnel, and surgeons that counts.

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