This case report emphasizes the role of Assertive Community Treatment (ACT)in managing a family with four members suffering from mental illness, mainly schizophrenia. We report a case of middle-aged lady who was diagnosed with treatment resistant schizophrenia (TRS) living with two other family members with the same illness and their carer who developed major depression from shouldering the burden of caring for mentally ill family members. ACT, through its holistic approach, proved to have reduced hospitalizations and improve symptom control and quality of life in this family.
Schizophrenia

Foreign body (FB) ingestion among children is one of the most common presenting complaint to Emergency Department. Oropharyngeal foreign body are the least common, 5-10% in all FB ingestion. However, it carries significant mortality and morbidity following complications which may arise from it. Airway obstruction is one of the complications which may present after FB ingestion. Due to the significant differences in airway anatomy and physiology of children, management of an obstructed pediatric airway is challenging. It requires proper skill and experience to prevent further fatal complications. Proper assessment and airway evaluation are crucial before proceeding with endotracheal intubation. Surgical airway is only reserved in ‘Cannot Ventilate Cannot Intubate’ situation where it should be done by a skilled person, as it carries risk of injury to underlying vital structures.

Patients with Wellen’s syndrome often present with chest pain and found to have specific precordial T-wave changes on the electrocardiogram (ECG). They subsequently develop a large anterior wall myocardial infarction. These specific electrocardiographic abnormalities are associated with critical stenosis of the proximal left anterior descending coronary artery (LAD). This syndrome is often under-recognised and has fatal consequences; it is, therefore, also known as the widow maker. We highlight a case of a 39-year old gentleman who had a history of coronary artery disease and typical ECG characteristics of Wellen’s syndrome.
Electrocardiography ; chest pain

Aims: The presents study examines the purification and characterization of a chitinase from S. maltophilia SJ602 strain isolated from a soil sample collected from Jamia Hamdard, New Delhi. Methodology and Results: The purification steps included chitin affinity using colloidal chitin as the affinity matrix and column chromatography using Sephadex G-100. The chitinase was purified to 66 fold having a yield of 17%. The molecular weight of the chitinase was found to be around 29 kDa by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). The pH and temperature optima of the purified chitinase were found to be at pH 5.5 and 60 °C, respectively. Conclusion, Significance and Impact of the study: Besides showing a significant yield, the enzyme has a high thermal stability which has its applicability in the recycling of chitin waste.

Hypopygiopsis violacea, a species of fly of forensic importance, was recovered from a corpse and described for the first time. The morphological structures of the second and third instar larvae of four specimens were examined using light microscope. Observations were focused on three main morphological characters: cephalopharyngeal skeleton, anterior and posterior spiracles. Cephalopharyngeal skeleton of second instar larva is darkly pigmented and without accessory sclerite below the mouth hook. The anterior spiracles of second and third instar larvae have 8-9 papillae each, arranged in a single row. The posterior spiracle of second instar larva has two spiracular slits with no thickening of peritreme. This differentiates it from the third instar, whereby the latter has three slits for each posterior spiracle. Cephalopharyngeal skeleton of third instar larva is heavily pigmented. An accessory sclerite is found below the hook part of third instar larva but is absent in second instar. Peritreme of the posterior spiracle of third instar larva is thick almost complete encircling a button. The intersegmental spines of the cuticular surface are dome-shaped and unicuspid. Third instar larva of this species is large with size approximately 15 mm long. These findings provide important identification features of immature stages of Hy. violacea which could be useful in forensic entomology.

This report stresses on the occurrence of a rare adverse reaction to clozapine, i.e. allergic cutaneous and visceral angioedema, in a patient with treatment resistant schizophrenia (TRS). We report the case of a schizophrenic patient who was resistant to treatment and developed an allergic reaction involving her skin and gastro-intestinal system upon the commencement of clozapine. She was then treated with a combination pharmacotherapy which left some residual symptoms. The manifestation of allergic reactions to clozapine and its management strategies are discussed in the paper. There is a pressing need to develop a new psychotropic which is on par with clozapine.
Schizophrenia ; Clozapine

Learning is important for the development of children with special needs. Slow learners, which are included in the special-needs category suffer from extreme timidity thus making them unable to actively involved in learning sessions. It is important for them to actively involve in the learning activities as it affects their academic achievement. This study involves two phases of activities which are; Phase 1, identification specification through literature review and expert interview, and Phase 2, model development. From the specification identification phase, suitable elements and components are identified, gathered, analysed and organised to prepare a comprehensive model. Therefore, a robotic-based model for slow learners’ learning is proposed. The model consists of the elements and the components that emphasize interactive student-centred learning. The model is derived from Care-Receiving Robot, Social Development Theory and Triple-D Model which consists of the teacher (More Knowledgable Other), the student, the robot (Care-Receiving Robot), learning by teaching to invoke student-centred learning, and evaluation (Triple-D Model).

Driving posture is one of the factors that need to be emphasized in ensuring driver’s comfort and to avoid road accidents and injuries. Meanwhile, fatigue has a strong relationship with comfortable posture and it contributes 15.7% of the total road accidents in Malaysia. Fatigue can reduce driving concentration and performances, thus increases the risk of road accidents and injuries. In order to determine the driver’s comfort, this study had measured muscle contraction using the objective measurement for comfortable and optimum driving posture angles. The equipment used for conducting objective measurement on 14 respondents was sEMG. The researcher had used sEMG equipment to evaluate muscles activities at upper extremities, which comprises of Biceps Brachii (BB), Deltoid Anterior (DA) and Trapezious Upper (TU) that were involved during controlling the car steering. It involves three driving postures parameters according to the fixed elbow and shoulder angles. The results from this study showed the BB muscle increased positively when turning the steering wheel to the right within 3 to 6 times value increased. Meanwhile, DA and TU muscles experience a contraction in the opposite direction with steering wheel turning action, which shows higher right side DA and TU muscle contraction when the driver turn the steering to the left with around 80% decrease for DA and within 60% to 80% decrease value for TU. BB muscle also shows an increasing value of muscle contraction with higher elbow flexion, meanwhile DA and TU muscles contraction also show an increment in-line with greater shoulder abduction. The results showed that posture B with elbow angle at 36° and shoulder angle at 134° are the most comfortable driving postures, hence the lowest muscle contraction value of 15.67μV (BB), 19.31μV (DA) and 12.36μV (TU) compared to the other two measured postures. The results of muscle contraction from this study is capable of assisting researchers and car manufacturers to understand the relationship of steering maneuvering when developing more comfortable and suitable vehicle’s driver seat compartment.

This study was conducted to analyses the Biceps Brachii (BB) muscle contraction during different driving postures. Drivers’ posture is one of the factors that contribute to driving fatigue that eventually may lead to road accident and injuries. The experiment conducted for this study is using the surface electromyography (SEMG) method for objective evaluation of muscle involved in driving activities. A total of 14 participants are involved in the experiment. The experiment was done on three different posture based on comfortable angles published by previous research. From the results analysis, the RMS value for activity left turn is lower than activity for right turn for all three postures and results also shows that posture B with elbow angle of 134° is perceived as most comfortable based on the lowest value of muscle contraction with a value of 15.67μV. The outcomes from this study are hoped to benefit both manufactures and also car users in ensuring better and optimum driving postures that can avoid fatigue and injuries.
comfort ; seat design ; surface electromyography ; driving posture ; muscle contraction

A one year study was carried out to determine the outcome of the seminal fluid parameters collected via masturbation and coitus interruptus in 151 patients who were undergoing intrauterine insemination (IUI) and patients who came for seminal analysis. There were no statistically significant differences in terms of volume, concentration, progressive motility and normal morphology from specimens collected via coitus interruptus compared to specimens collected via masturbation. Pregnancy outcomes were also comparable.