Attention-deficit hyperactive disorder presenting with school truancy in an adolescent: a case report

Attention-deficit hyperactive disorder (ADHD) is a psychiatric illness commonly diagnosed during the early years of childhood. In many adolescents with undiagnosed ADHD, presentation may not be entirely similar to that in younger children. These adolescents pose significant challenges to parents and teachers coping with their disability. Often adolescents with behavioural problems are brought to medical attention as a last resort. This case describes an adolescent who presented to a primary care clinic with school truancy. He was initially treated for depression with oppositional defiant disorder and sibling rivalry. Only following a careful detailed history and further investigations was the diagnosis of ADHD made. He showed a positive improvement with the use of methylphenidate for his ADHD and escitalopram for his depression. The success of his management was further supported by the use of behavioural therapy and parenting interventions. There is a need to increase public awareness of ADHD, especially among parents and teachers so that early intervention can be instituted in these children.     

Eutrophication,agriculture and water level control shift aquatic plant communities from floating-leaved to submerged macrophytes in Lake Chini,Malaysia

In this study we: (1) present a quantitative spatial analysis of the macrophyte communities in Lake Chini with a focus on the biogeographical distributions of the native Nelumbo nucifera and the invasive Cabomba furcata; (2) examine the environmental changes that affect plant community composition; and (3) outline a conceptual model of the variation of ecological processes that shape the macrophyte communities. Plant species cover, biomass of C. furcata and N. nucifera, and water quality and environmental variables were measured before and after monsoonal floods in September 2009 and April 2010. Permutational multivariate analysis was used to examine the significance of the invasion of C. furcata at different spatial scales. Relationships between plant species cover and environmental variables before and after flooding were examined using principal coordinates analysis and non-parametric multivariate multiple regressions. Our findings suggest that (1) Variation in plant communities was significant at the lake scale and the distribution of plant species changed after annual floods. (2) Invasion by C. furcata significantly affected the overall plant community composition. (3) C. furcata biomass increased after the monsoonal season, which indicates that C. furcata is adapted to flooding events and that it is becoming increasingly abundant. (4) In addition to the strong monsoonal effect, total depth, nutrient concentration, and sediment type were important environmental variables that significantly affected plant community composition. The macrophyte community in Lake Chini is highly dynamic. The spatial and temporal plant community dynamics are associated with flood regime, water quality, and substrate. Human-induced changes in these parameters are likely shifting the macrophyte dominance from floating-leaved to submerged species.