CD19 Deficient B Cell Abnormality and Selective IgM Deficiency in a Malay Child. A Case Report.

Cases of CD 19 deficiency from South East Asia has rarely been reported. A, 1l yr Malay boy was referred with recurrent infections with 2 episodes of'chickenpox at age 2 years. He had repeated episodes of pneumoniae and bronchiectasis by age 6 years. Physical examination revealed gross clubbing with crepitations at both lung bases. IV lg administration was instituted with clinical improvementlaboratory data: Serum Ig (g/l )IgG 8.37[n 4.95- 16.56 ], IgA 0.92[n 0.30-2.35 7, lgM 0.21 [0.32-1.4}]Lymphocyte subset (age 1l) CD19 Q o , CD20 11.26% (12-22)CD3 83.64% (n 66-76) ,CD4 36.25 ( 33-41),CD8 41.55 (27- 35), CDl6+56 I1.6 %. (9-16),Specific antibody response to polysaccharide antigen was impaired ; whileNBT , lymphocyte proliferation to (PHA ) were normal, Btk protein 18% (control 87.8 %). Our finding conforms with a diagnosis of CD19 deficiency with selective IgM deficiency and partial defective Btk protein expression

The Effect of Nicotine Dependence on Psychopathology in Patients with Schizophrenia

Introduction. Our study aims to determine the prevalence of nicotine dependence and investigate the effect of nicotine dependence on psychopathology among schizophrenia patients. Methods. A cross-sectional study was carried out in an outpatient psychiatric clinic at a general hospital in Malaysia. 180 recruited subjects were administered the Malay version of Mini International Neuropsychiatric Interview (MINI), the Positive and Negative Symptom Scale (PANSS), and the Malay version of Fagerstrom Test for Nicotine Dependence (FTND-M) questionnaires. Results. The prevalence of nicotine dependence among the subjects was 38.1% () and they were mainly composed of male gender, Malay ethnicity, being treated with atypical antipsychotics, and taking other illicit drugs or alcohol. Subjects with severe nicotine dependence scored less in the negative subscale of PANSS compared with the nonsmokers (). On performing the hierarchy multiple regressions, dependence status still significantly predicted negative scores after adjusting the confounders (, ). Conclusion. The rate of nicotine use disorder among schizophrenia patients in this study is higher than that of the general population in Malaysia. The significant association between nicotine dependence and negative psychopathology symptoms will help the healthcare practitioners in their management of nicotine dependence among schizophrenia patients

EPIdemiology of Surgery-Associated Acute Kidney Injury (EPIS-AKI) : Study protocol for a multicentre, observational trial

More than 300 million surgical procedures are performed each year. Acute kidney injury (AKI) is a common complication after major surgery and is associated with adverse short-term and long-term outcomes. However, there is a large variation in the incidence of reported AKI rates. The establishment of an accurate epidemiology of surgery-associated AKI is important for healthcare policy, quality initiatives, clinical trials, as well as for improving guidelines. The objective of the Epidemiology of Surgery-associated Acute Kidney Injury (EPIS-AKI) trial is to prospectively evaluate the epidemiology of AKI after major surgery using the latest Kidney Disease: Improving Global Outcomes (KDIGO) consensus definition of AKI. EPIS-AKI is an international prospective, observational, multicentre cohort study including 10 000 patients undergoing major surgery who are subsequently admitted to the ICU or a similar high dependency unit. The primary endpoint is the incidence of AKI within 72 hours after surgery according to the KDIGO criteria. Secondary endpoints include use of renal replacement therapy (RRT), mortality during ICU and hospital stay, length of ICU and hospital stay and major adverse kidney events (combined endpoint consisting of persistent renal dysfunction, RRT and mortality) at day 90. Further, we will evaluate preoperative and intraoperative risk factors affecting the incidence of postoperative AKI. In an add-on analysis, we will assess urinary biomarkers for early detection of AKI. EPIS-AKI has been approved by the leading Ethics Committee of the Medical Council North Rhine-Westphalia, of the Westphalian Wilhelms-University Münster and the corresponding Ethics Committee at each participating site. Results will be disseminated widely and published in peer-reviewed journals, presented at conferences and used to design further AKI-related trials. Trial registration number NCT04165369

Risk analysis approach for generation adequacy assessment in a deregulated environment

A system operator (SO) of a transmission network consistently aims to minimise operating costs whilst still maintaining a certain degree of system adequacy. One of the ways to achieve this is by minimising the level of spinning reserve (SR) in the system. In order to do so, the level of SR must be analysed. This study looks at quantifying the risk of inadequacy when the SR is varied. A study was done for a period of 24?h with 30?m intervals to determine the risk level at each period. The number of generators despatched, system power margin and the system sell price was all taken into account. Risk was then computed by factoring the probability of generation inadequacy and the cost of purchasing the imbalance from the balancing market

The Use of Clozapine In An Asian Child With Schizophrenia

Introduction: This is a report of an Asian child with schizophrenia on clozapine. Clozapine is often used as the last line treatment for patients with schizophrenia. Its use in children has been strictly “off label”. In our Psychiatry Adolescent and Child Unit (PAC) in University Malaya Medical Center (UMMC), we have only two children on this treatment of which one will be highlighted in this report. Objective: To report a unique experience on the use of clozapine in an Asian child. Method: A case report study. Conclusion: This case report highlights the usefulness and challenges of this medication in children with this illness. It is hoped that this report will give more weight to the current body of knowledge and also encourage us to benefit from this highly useful medication for the betterment of our child patients

The use of clozapine in adolescents: A case report

We report or a young adolescent diagnosed with early-onset schizophrenia and subsequently treated with clozapine. Clozapine is often used as the last line of treatment for patients with schizopirenia, even in the paediatric population. This report highlights the usefulness and challenges of using clozapine in adolescents with schizophrenia

Comparative performance of water hyacinth (Eichhornia crassipes) and water lettuce (Pista stratiotes) in preventing nutrients build-up in municipal wastewater

Studies on removal of nutrients from domestic wastewater using water hyacinth (Eichhornia crassipes) and water lettuce (Pista stratiotes) were conducted. The plants were grown in 68 L of wastewater with 21-day retention period in fiber-glass tanks with another similar tank as control. Eichhornia crassipes performed better than P. stratiotes in reducing the concentrations of nitrate-nitrogen and ortho-phosphates while P. stratiotes performed better than E. crassipes in reducing the concentrations of ammoniacal-nitrogen (NH4-N) and nitrite-nitrogen. On average, E. crassipes reduced the NH4-N concentration by 72, P. stratiotes reduced the concentration by 83 and the concentration in the control was reduced by 95. On average, E. crassipes reduced the phosphate concentration by 55, P. stratiotes reduced the concentration by 60 and the concentration in the control increased by 28. Algae significantly reduced the concentration of NH4-N

Post occupancy evaluation of private housing in Pakistan

Need of housing and need of quality housing are two issues which remained the subject of research and interest to researchers’ and designers’. Whenever designers complete projects, they are not fully aware of the consequences of their designs. Only through a post occupational survey, the designer usually realizes the mistakes or bad decisions they have taken during the design process. Unfortunately, such unforeseen conditions are the part of daily life for end users of residential buildings in developing regions. The main purpose of this research is to understand and identify the causes of design deficiencies and their effects on residential buildings at post occupational stage in Karachi, Pakistan. Housing designs need to be closely monitored and need to be synchronized with well tested and established criteria and standards of housing. Other factors which influence the housing design and quality, to name a few, are high price of land, institutional control and unqualified personnel. This research circumscribes the issues and problems faced by the users of private housing at post occupational stage, which have resulted from deficient designs. These problems affect the users from unplanned maintenance to major repairs leading to danger of collapse. In order to evaluate these effects on buildings, a case study was conducted in low and medium cost housing stock in Karachi, a metropolitan city of Pakistan. The data for research was collected and analysed through computation and interpreted to understand the far reaching effects and implications of design deficiencies in low and medium cost housing stocks of Karach

Novel Indole-Pyrazine Alkaloid: Synthesis, Characterization, and Crystal Structure

A heterocyclic molecule of a novel class with a multiple ring system has been synthesized using a new and simple strategy and acetic acid as catalyst. The structure of the title molecule has been determined by spectral analysis and single crystal X-ray diffraction analysis. The compound crystallizes in monoclinic system, space group P21/c, with two crystallographically independent molecules in an asymmetric unit. The two molecules show close comparable geometric parameters and a similar conformation of fused-ring systems. The crystal structure is stabilized by a combination of N–H⋅⋅⋅O and C–H⋅⋅⋅O hydrogen bonds, where independent molecules display equivalent interaction patterns