MyMedR

Displaying publications 1 - 20 of 28 in total

Abstract:

Sort:

Pattern of suicides in 2009: data from the National Suicide Registry Malaysia

Ali NH, Zainun KA, Bahar N, Haniff J, Hamid AM, Bujang MA, et al.

Asia Pac Psychiatry, 2014 Jun;6(2):217-25.
PMID: 23857761 DOI: 10.1111/j.1758-5872.2012.00227.x

The National Suicide Registry Malaysia (NSRM) is a nationwide system that captures data on completed suicides in Malaysia from all forensic departments under the purview of the Ministry of Health Malaysia.
Fatal injuries among motorcyclists in Klang Valley, Malaysia

Ramli R, Oxley J, Noor FM, Abdullah NK, Mahmood MS, Tajuddin AK, et al.

J Forensic Leg Med, 2014 Aug;26:39-45.
PMID: 25066171 DOI: 10.1016/j.jflm.2014.06.007

Motorcycle fatalities constitute the majority of road traffic deaths in Malaysia. The aims of this study were to describe the pattern of fatal injuries among Klang Valley fatal motorcyclists and to describe the factors associated with fatal (vs non-fatal) injuries.
Fulltext Clostridial aortitis causing ruptured dissecting aneurysm in a young adult female

Subramaniam K, Hasmi AH, Mahmood MS

Malays J Pathol, 2014 Dec;36(3):213-6.
PMID: 25500522 MyJurnal

Ruptured dissecting aortic aneurysm more commonly occur in men in the 40 to 70 age group, and most commonly is associated with atherosclerosis. Uncommon causes are previous heart surgery, connective tissue disorders and aortitis. Despite its rarity, Clostridium spp aortitis progresses very rapidly with a mortality rate of approximately 79% in adults, typically occurring within 48 hours of infection. We present a case of sudden death due to clostridial aortitis causing ruptured aortic dissection in an apparently healthy adult female, 7 weeks post-spontaneous vaginal delivery. This case highlights the pathology of aortic dissection and cystic media necrosis as presentations of clostridium spp infection in young female adult.
Fulltext Suicide in the elderly in Malaysia

Rahimi R, Ali N, Md Noor S, Mahmood MS, Zainun KA

Malays J Pathol, 2015 Dec;37(3):259-63.
PMID: 26712672 MyJurnal

Suicidal feelings and a sense of hopelessness have been regarded as part of the ageing process more so in the context of being elderly and having physical difficulties. As older adults are the fastest growing population in the world, suicides among this population is also expected to increase. The authors retrospectively reviewed all cases recorded by the National Suicide Registry Malaysia (NSRM) for the year 2009. Suicide in victims 65 years and older totaled 23 in number and accounted for 7.1% of all suicides. All the cases were autopsied. The case records were retrospectively analyzed with respect to age, gender, ethnicity and method of death. Comparisons were also made between males and females, levels of education, presence of stressor and life events antecedent to suicide. The ages of these suicide victims ranged from 65 to 94 years. Men comprised almost 70% of the cases. The average age of the victim was 73 years. Hanging was the most common method of suicide, accounting for 56.5% of the cases. Other methods included jumping from height (13.1%), exposure to unspecified chemicals (13.1% ), jumping/lying before moving object (4.3%), exposure to pesticides (4.3%) and injuring oneself using sharp object (4.3%). Death of a loved one, legal problems, financial problems and physical illness were the stressors identified contributing to the suicide act.
Fulltext MH17: the Malaysian experience

Khoo LS, Hasmi AH, Abdul Ghani Aziz SA, Ibrahim MA, Mahmood MS

Malays J Pathol, 2016 Apr;38(1):1-10.
PMID: 27126658 MyJurnal

A disaster is a natural or man-made (or technological) hazard resulting in an event of substantial extent causing significant physical damage or destruction, loss of life, or drastic change to the environment. It is a phenomenon that can cause damage to life and property and destroy the economic, social and cultural life of the people; and overwhelms the capacity of the community to cope with the event. The recent tragic aviation accidents in 2014 involving Malaysia Airlines flights MH370 and MH17 shocked the world in an unprecedented manner. This paper focuses on the Malaysian experience in the MH17 mission in Ukraine as well as the first ever international Disaster Victim Identification (DVI) operation for the Malaysian DVI team. The DVI operations in Hilversum, the Netherlands were well described in stages. The Netherlands' Landelijk Team Forensische Opsporing as the lead DVI team in Hilversum operated systematically, ensuring the success of the whole mission. This paper discusses the lessons learned by the Malaysian team on proper DVI structure, inter- and intra-agency cooperation, facilities planning and set up, logistics and health and safety aspects, as well as effective communication and collaboration with other international delegates. Several issues and challenges faced by the Malaysian team were also documented. In addition, the authors shared views, opinions and recommendations for a more comprehensive DVI operation in the future.
Underwater DVI: Simple fingerprint technique for positive identification

Khoo LS, Hasmi AH, Mahmood MS, Vanezis P

Forensic Sci Int, 2016 Sep;266:e4-e9.
PMID: 27567043 DOI: 10.1016/j.forsciint.2016.08.019

An underwater disaster can be declared when a maritime accident occurred or when an aircraft is plunged into water area, be it ocean, sea or river. Nevertheless, handling of human remains in an underwater recovery operation is often a difficult and demanding task as working conditions may be challenging with poor to no visibility, location of remains at considerable depths and associated hazards from surrounding water. A case of the recent helicopter crash, into a famous river in Sarawak, domiciled by huge crocodiles, is discussed in this paper. Search and recovery team as well as the combat divers from the Special Elite Troop Commando, known as VAT 69, were deployed to the scene to perform the underwater recovery to search for all the victims on board involving five Malaysians with a pilot of Philippines nationality. This paper highlights the limitations and challenges faced during the underwater search and recovery. All the bodies recovered were in moderate decomposition stage with crushed injuries and mutilated face and body. A simple and conventional fingerprint technique were used to record the fingerprint. The prints impressions were later photographed using a smartphone and transferred back to the RMP headquarters in Kuala Lumpur for fingerprint match by using WhatsApp Messenger, a phone application. All the first five victims were identified within an average of 10min. The last victim recovered was the pilot. For foreign nationals, the Immigration Department of Malaysia will record the prints of both index fingers only. The lifting of the fingerprint of the last victim was the most challenging in which only one index finger left that can be used for comparison. A few techniques were attempted using the black printer's ink, glass and tape techniques for the last victim. Subsequently, images of the prints impression were taken using the same smartphone with additional macro lens attached to it to enhance the resolution. The images were transferred to the RMP headquarters through WhatsApp Messenger. The prints were confirmed to be the pilot 20min later.
Fulltext Updates on knowledge, attitude and preventive practices on tuberculosis among healthcare workers

Abd Wahab F, Abdullah S, Abdullah JM, Jaafar H, Md Noor SS, Wan Mohammad WMZ, et al.

Malays J Med Sci, 2016 Nov;23(6):25-34.
PMID: 28090176 MyJurnal DOI: 10.21315/mjms2016.23.6.3

Ranking as the most communicable disease killer worldwide, tuberculosis, has accounted with a total of 9.6 million new tuberculosis cases with 1.5 million tuberculosis-related deaths reported globally in 2014. Tuberculosis has remain as an occupational hazard for healthcare workers since 1920s and due to several tuberculosis outbreaks in healthcare settings in the early 1990s, the concern about the transmission to both patients and healthcare workers has been raised. Healthcare workers have two to three folds greater the risk of active tuberculosis than the general population. Several studies on knowledge, attitude and practices on tuberculosis among healthcare workers worldwide have revealed that majority of the participated healthcare workers had good knowledge on tuberculosis. Most of the healthcare workers from South India and South Africa also reported to have positive attitude whereas a study in Thailand reported that most of the healthcare providers have negative attitude towards tuberculosis patients. Nevertheless, majority of the healthcare workers have low level of practice on tuberculosis prevention. An improved communication between healthcare workers and the patients as well as their families is the key to better therapeutic outcomes with good knowledge, attitude and preventive practice towards tuberculosis.
The clandestine multiple graves in Malaysia: The first mass identification operation of human skeletal remains

Mohd Noor MS, Khoo LS, Zamaliana Alias WZ, Hasmi AH, Ibrahim MA, Mahmood MS

Forensic Sci Int, 2017 Sep;278:410.e1-410.e9.
PMID: 28698062 DOI: 10.1016/j.forsciint.2017.05.014

The first ever mass identification operation of skeletal remains conducted for the clandestine graves in Malaysia consisted of 165 individuals unearthed from 28 human trafficking transit camps located in Wang Kelian, along the Thai-Malaysia border. A DVI response was triggered in which expert teams comprising of pathologists, anthropologists, odontologists, radiologists and DNA experts were gathered at the identified operation centre. The Department of Forensic Medicine, Hospital Sultanah Bahiyah, Alor Star, Kedah, located approximately 75km away from Wang Kelian, was temporarily converted into a victim identification centre (VIC) as it is the nearest available forensic facility to the mass grave site. The mortuary operation was conducted over a period of 3 months from June to September 2015, and was divided into two phases; phase 1 involving the postmortem examination of the remains of 116 suspected individuals and for phase 2 the remains of 49 suspected individuals. The fact that the graves were of unknown individuals afforded the mass identification operation a sufficient duration of 2 weeks as preparatory phase enabling procedurals and daily victim identification workflow to be established, and the setting up of a temporary body storage for the designated mortuary. The temporary body storage has proven to be a significant factor in enabling the successful conclusion of the VIC operation to the final phase of temporary controlled burials. Recognition from two international observers, Mr. Andréas Patiño Umaña, from the International Committee of Red Cross (ICRC) and Prof. Noel Woodford from Victoria Institute of Forensic Medicine (VIFM) had proven the mortuary operation was in compliance to the international quality and standards. The overall victim identification and mortuary operation identified a number of significant challenges, in particular the management of commingled human remains as well as the compilation of postmortem data in the absence of antemortem data for future reconciliation. CF Index in this DVI operation is 9%, indicating the primary identifications in this operation were effective. Limitations and further improvements of the mass identification operation will be discussed. This paper details the planning, preparations and management of the mass identification operation on the exhumed human remains which was also a forensic humanitarian service for the dead with dignity and respect.
Oryong 501 sinking incident in the Bering Sea-International DVI cooperation in the Asia Pacific

Chung NE, Castilani A, Tierra WE, Beh P, Mahmood MS

Forensic Sci Int, 2017 Sep;278:367-373.
PMID: 28806635 DOI: 10.1016/j.forsciint.2017.07.030

On December 1st, 2014, the sinking of Oryong 501 occurred in the Bering Sea off the east coast of Russia. A total of 60 crew members, including 35 Indonesians, 13 Filipinos, 11 South Koreans and 1 Russian inspector were on board out of which only seven survived. Through an international rescue operation, the dead bodies of 27 were found and the remaining 26 crew are still missing. After transferring the dead bodies to the Busan Harbor in South Korea, the operation to identify the deceased began involving DVI teams from three countries: Korea, Indonesia and the Philippines. When a deep sea fishing boat sinks, it is very difficult to obtain antemortem data of the crew who had been on board for a long time. This is especially so if the crews are multinational. Further, the accuracy of the antemortem data provided by the families may be questionable, and the provided data is often not standardized. Despite the fact that the antemortem data were received in different formats, the identification process for the bodies of the 27 crew from the Oryong sinking was quickly completed through the cooperation among the three DVI teams. This case is an excellent example of how efficiently a DVI operation can be conducted in the Asia Pacific region. Issues raised during this operation should enable even better preparation for similar events in the future.
New Insight into the Origin of the Red/Near-Infrared Intense Fluorescence of a Crystalline 2-Hydroxychalcone Derivative: A Comprehensive Picture from the Excited-State Femtosecond Dynamics

Zahid NI, Mahmood MS, Subramanian B, Mohd Said S, Abou-Zied OK

J Phys Chem Lett, 2017 Nov 16;8(22):5603-5608.
PMID: 29094952 DOI: 10.1021/acs.jpclett.7b02601

Fluorescence upconversion and transient absorption techniques are used to explain the source of the intense red/near-infrared emission of crystalline 4-dimethylamino-2'-hydroxychalcone. We found that the initially excited enol form undergoes tautomerization in 3 ps to form the keto tautomer. The latter is stable in the ground state as a consequence of J-type aggregation in the crystal packing and is manifested in an absorption peak at 550 nm that spectrally overlaps with the short-lived enol emission, leading to self-reabsorption and adding a factor to the complete depletion of the enol emission. Relaxation of the keto tautomer takes place in the form of intense fluorescence (600-750 nm) with 1.7 ns lifetime. The different spectroscopy in solution is due to vibrational cooling (300 fs), followed by solvation dynamics (5 ps in methanol) and twisting of the hydroxyphenyl ring (16 ps), before relaxation of the enol tautomer in the form of weak green fluorescence with 350 ps lifetime.
Cling film plastic wrap: An innovation for dead body packaging, preservation and transportation by first responders as a replacement for cadaver body bag in large scale disasters

Khoo LS, Lai PS, Saidin MH, Noor Z, Mahmood MS

Forensic Sci Int, 2018 Apr;285:50-57.
PMID: 29433011 DOI: 10.1016/j.forsciint.2018.01.018

Cadaver body bags are the conventional method to contain a human body or human remains, which includes the use for storage and transportation of the deceased at any crime scene or disaster scene. During disasters, most often than not, the first responders including the police will be equipped with cadaver body bags to do scene processing of human remains and collection of personal belongings at the disaster site. However, in an unanticipated large scale disasters involving hundreds and thousands of fatalities, cadaver body bags supplies may be scarce. The authors have therefore innovated the cling film plastic wrap as an alternative for the cadaver body bag used at the disaster site. The plastic wrap was tested on six different experimental subjects, i.e. both adult and child mannequins; body parts of the mannequin figure (arm and hand); a human adult subject and an unknown dead body. The strengths of the cling film plastic wrap are discussed in comparison with the cadaver body bag in the aspects of costing, weight, duration of the wrap, water and body fluid resistant properties, visibility and other advantages. An average savings of more than 5000% are noted for both adult body wrap and child body wrap compared to the cadaver body wrap. This simply means that the authors can either wrap 25 adult dead bodies or 80 children dead bodies with the cost of 1 cadaver body bag. The cling film plastic wrap has proven to have significant innovation impact for dead body management particularly by the first responders in large scale disasters. With proper handling of dead bodies, first responders can manage the dead with dignity and respect in an overwhelmed situation to facilitate the humanitarian victim identification process later.
Fulltext Manifestation of Coronary Atherosclerosis in Klang Valley, Malaysia: An Autopsy Study

Rahimi R, Singh MKC, Noor NM, Omar E, Noor SM, Mahmood MS, et al.

J Atheroscler Thromb, 2018 May 01;25(5):405-409.
PMID: 29118310 DOI: 10.5551/jat.39107

AIMS: The present study aimed to determine the epidemiological aspects of medico-legal autopsies and manifestation of coronary atherosclerosis.
METHODS: This was a cross sectional study involving 222 cases recruited from National Institute of Forensic Medicine (NIFM) Hospital Kuala Lumpur (HKL) and Department of Forensic Medicine Hospital Sungai Buloh (HSgB) for a period of 15 months, from December 2012 to April 2014. Sociodemographic and autopsy findings, including the cause and manner of death were documented.
RESULTS: Male and female subjects aged 18-70 years were recruited. Males contributed to 86% of the total subjects and comprised 61% of young adults. Road traffic accidents were the primary cause of death, contributing almost 50% of the subjects. One third of the cases comprised of death due to natural causes, wherein almost 75% of the subjects within this category succumbed to sudden cardiac death. Coronary artery disease (CAD) contributed to 60% of the sudden cardiac death (SCD). Single and double-vessel diseases were the most common pattern of atherosclerosis. In almost 80% of CAD cases, atherosclerosis affected the left anterior descending artery (LAD).
CONCLUSION: Cardiovascular diseases were the most significant natural cause of sudden death with a staggering figure of 75%. CAD was the single most commonly encountered pathology within the SCD. Most cases presented with single and double-vessel diseases, observed in all subjects, as well as the young adult population.
Reprint of: Cling film plastic wrap: An innovation for dead body packaging, preservation and transportation by first responders as a replacement for cadaver body bag in large scale disasters

Khoo LS, Lai PS, Saidin MH, Noor Z, Mahmood MS

Forensic Sci Int, 2018 Jul;288:242-255.
PMID: 29783180 DOI: 10.1016/j.forsciint.2018.04.017

Cadaver body bags are the conventional method to contain a human body or human remains, which includes the use for storage and transportation of the deceased at any crime scene or disaster scene. During disasters, most often than not, the first responders including the police will be equipped with cadaver body bags to do scene processing of human remains and collection of personal belongings at the disaster site. However, in an unanticipated large scale disasters involving hundreds and thousands of fatalities, cadaver body bags supplies may be scarce. The authors have therefore innovated the cling film plastic wrap as an alternative for the cadaver body bag used at the disaster site. The plastic wrap was tested on six different experimental subjects, i.e. both adult and child mannequins; body parts of the mannequin figure (arm and hand); a human adult subject and an unknown dead body. The strengths of the cling film plastic wrap are discussed in comparison with the cadaver body bag in the aspects of costing, weight, duration of the wrap, water and body fluid resistant properties, visibility and other advantages. An average savings of more than 5000% are noted for both adult body wrap and child body wrap compared to the cadaver body wrap. This simply means that the authors can either wrap 25 adult dead bodies or 80 children dead bodies with the cost of 1 cadaver body bag. The cling film plastic wrap has proven to have significant innovation impact for dead body management particularly by the first responders in large scale disasters. With proper handling of dead bodies, first responders can manage the dead with dignity and respect in an overwhelmed situation to facilitate the humanitarian victim identification process later.
Human tuberculosis brain promotes neuronal apoptosis but not in astrocytes with high expression of vascular endothelial growth factor

Othman FN, Muthuraju S, Noor SSM, Abdullah S, Mohd Yusoff AA, Tharakan J, et al.

Tuberculosis (Edinb), 2018 09;112:45-51.
PMID: 30205968 DOI: 10.1016/j.tube.2018.07.007

The present study aimed to investigate the involvement of the angiogenic marker vascular endothelia growth factor (VEGF) and apoptotic markers of Bcl-2 and Bax in the neurons and astrocytes in the brain infected by Mycobacterium tuberculosis. The immunohistochemistry staining was performed to analyze the expression of the VEGF, Bcl-2 and Bax in the astrocytes and neurons. The expression of VEGF was high in neurons and astrocytes in both the infected brain and control tissues with no difference of angiogenic activity (p = 0.40). Higher Bcl-2 expression was seen in astrocytes of infected brain tissues compared to the control tissues (p = 0.004) promoted a higher anti-apoptotic activity in astrocytes. The neurons expressed strong Bax expression in the infected brain tissues compared to the control tissues (p 
Sudden cardiac death in a young adult man due to spontaneous coronary artery dissection

Subramaniam K, Siew SF, Mahmood MS

Malays J Pathol, 2019 Apr;41(1):51-54.
PMID: 31025638

Spontaneous coronary artery dissection is a rare event and commonly associated with pregnancy and female gender. This condition can reduce or completely obstruct the blood flow to the heart, causing a myocardial ischaemia, abnormalities in heart rhythm or sudden death. We present a case of a 28-year-old Indian male with no previous medical illness who complained sudden onset of chest pain prior to his death. Autopsy revealed a left anterior descending coronary artery dissection associated with plaque rupture. The anterior wall of left ventricle showed contraction band necrosis. There was also atheroma present in the right coronary artery which was insignificant. Histologically, dissection was associated with atherosclerosis. There was no evidence of vasculitis. The cause of death was given as coronary artery dissection due to coronary artery atherosclerosis.
Association of coronary artery calcium score with calcification and degree of stenosis: An autopsy study

Kaur M, Rahimi R, Razali F, Mohd Noor N, Omar E, Abdul Manaf Z, et al.

Malays J Pathol, 2019 Aug;41(2):177-183.
PMID: 31427553

INTRODUCTION: Coronary artery disease (CAD) is a known cause of major cardiovascular events and calcium score (CS) has been developed as a marker of coronary atherosclerosis. Yet, the relationship between post mortem computed tomography (PMCT) CS with histologically observed calcification and the severity of coronary artery stenosis has not been widely explored and is still unclear. This study aims to determine the association between coronary artery PMCT CS with histologically observed calcification and degree of stenosis of coronary arteries in post-mortem cases.
MATERIALS & METHODS: This was a cross-sectional study involving 101 subjects recruited from the National Institute of Forensic Medicine (IPFN) Hospital Kuala Lumpur (HKL) over a period of 15 months, from December 2012 until April 2014. PMCT CS of the coronary arteries was calculated using Agatston-Janowitz score. Histological presence of calcification was observed and the degree of stenosis was calculated using an image analysis technique.
RESULTS: PMCT CS increased with increasing severity of stenosis (p<0.001). PMCT CS showed a positive correlation with the presence of calcification (r=-0.82, p<0.001).
CONCLUSION: Calcium score is strongly associated with coronary artery calcification and the degree of luminal stenosis in post mortem subjects. Thus, PMCT may be useful as a non-invasive tool in diagnosing CAD in the event that an autopsy is not possible.
Fulltext Postmortem CT scan in intoxication cases: A necessity or just an indulgence

Soon LP, Subramaniam K, Madon NF, Mohamad Noor MH, Chainchel Singh MK, Mahmood MS

Indian J Radiol Imaging, 2019 10 30;29(3):305-309.
PMID: 31741600 DOI: 10.4103/ijri.IJRI_2_19

Introduction: The aim of this study is to correlate urinary bladder distension and pulmonary edema on postmortem computed tomography (CT) scans with toxicology results in postmortem cases.
Methods and Results: The study population was the postmortem cases of Asian population ranging from 16 to 75 years old in which blood and/or urine samples sent for alcohol and/or drug of abuse (DoA) analysis in year 2016 at our centre. Out of 434 cases, 54 from each group of positive and negative alcohol and/or DoA. Postmortem findings of lungs and postmortem CT scan urinary bladder volume (UBV) were recorded. Statistical significant correlation was obtained between urinary bladder distension on postmortem CT scan and cases with positive alcohol detection. However, the sensitivity was relatively low at 51.7%, whereas the specificity was 75% at the cut-off point. Low sensitivity and specificity at around 52.7% were obtained for pulmonary edema related to alcohol/DoA. This showed that UBV alone or pulmonary edema alone was not really a good indicator for alcohol or DoA intoxication. However, combination of both indicators provided higher sensitivity (73.3%) although specificity was lowered to 53.8%.
Conclusion: The findings of postmortem CT scan bladder distension and pulmonary edema could possibly identify intoxication cases but not conclusive.
Sudden death due to infective endocarditis caused by Streptococcus constellatus: A case report

Zamasry MS, Hilmi Z, Mohd Yusof MYP, Razali HSA, Nawawi H, Mahmood MS

Trop Biomed, 2019 Dec 01;36(4):845-849.
PMID: 33597456

Infective endocarditis (IE) is a relatively uncommon disease, but has been challenging to diagnose over the years. With the increasing incidence, variety of causative agents and the resistance of microorganisms towards antibiotics, there is still an occurrence of sudden death due to undiagnosed IE. The most common microorganism causing IE is Staphylococcus aureus. However, there is increasing prevalence of other microorganisms causing IE. This case report highlights a case of sudden death due to IE caused by a rare pathogen, Streptococcus constellatus which belongs to the Streptococcus anginosus group (Milleri group). A study noted the crude incidence of IE in 6 world regions ranged between 1.5 and 11.6 cases per 100,000 people. To date, there has been no previous report on sudden death due to IE caused by Streptococcus constellatus in Malaysia, neither in the forensic nor clinical setting. This case report underlined the characteristics and pathological features of this microorganism. The increasing incidence and variety of causative organisms in IE are important public health issues. It is vital for future studies to examine the risk factors of IE related to Streptococcus constellatus, to enhance better understanding, insight and awareness regarding the course of this disease. This in turn may facilitate preventive measures to avoid morbidity and mortality from this condition.
Correlation and assessment of coronary artery luminal stenosis: Post-mortem computed tomography angiogram versus histopathology

Chainchel Singh MK, Abdul Rashid SN, Abdul Hamid S, Mahmood MS, Feng SS, Mohd Nawawi H, et al.

Forensic Sci Int, 2020 Mar;308:110171.
PMID: 32032870 DOI: 10.1016/j.forsciint.2020.110171

BACKGROUND: Post-mortem Computed Tomography (PMCT) allows non-invasive or minimally invasive detection of findings that may or may not be visible during conventional autopsy, however, it does not allow the investigator to draw any conclusions regarding patency of the vessel's lumen. To address this deficiency, Post-mortem Computed Tomography Angiography (PMCTA) utilizing different contrast media and techniques have been introduced with various studies looking at the correlation between PMCTA, autopsy (gross) findings and coronary artery histology in diagnosing coronary artery disease.
OBJECTIVES: The aim of this study is to investigate the sensitivity and specificity of PMCTA in diagnosing coronary artery stenosis using water-based contrast media introduced though the vessels of the neck, compared to the gold standard of diagnosis i.e. gross and histological evaluation of the coronary artery.
METHOD: This was a cross sectional study of 158 arterial sections involving 37 subjects recruited from the National Institute of Forensic Medicine (IPFN), Hospital Kuala Lumpur (HKL). An unenhanced PMCT was performed followed by PMCTA using water-based contrast media introduced though the vessels of the neck. Coronary artery stenosis was determined using multiplanar reconstructionD while the degree of stenosis was determined by calculating the percentage of luminal diameter divided by the diameter of the vessel internal elastic.
RESULTS: The analysis of PMCTA and histopathology examinations revealed a sensitivity of 61.5%, specificity of 91.7%; positive predictive value (PPV) of 40.0% and negative predictive value (NPV) of 96.4%.
CONCLUSION: PMCTA utilizing water-based contrast introduced though the vessels of the neck yielded similar results as other methods and techniques of PMCTA. We would therefore conclude that PMCTA utilizing this technique could be used to assess the degree of calcification and the presence of significant stenosis.
Methanol related death in National Institute of Forensic Medicine, Hospital Kuala Lumpur: A case series

Chng KL, Lai PS, Siew SF, Md Yaro SW, Mahmood MS

Malays J Pathol, 2020 Apr;42(1):99-105.
PMID: 32342937

INTRODUCTION: Methanol is a widely available chemical with a range of uses including as solvent, as a fuel, in chemical synthesis and anti-freeze preparations. Most of the cases are accidental exposures to drinking beverages contaminated with methanol.
MATERIALS AND METHODS: In mid-September 2018, there was a single outbreak of methanol poisoning in Malaysia especially involving the state of Federal Territory Kuala Lumpur and Selangor. There were 33 reported deaths suspected due to methanol poisoning in this current outbreak where 11 of them were brought in to the Institute of Forensic Medicine (NIFM), Kuala Lumpur. The last outbreak was in the year 2013 with 29 deaths reported out of 44 cases.
RESULTS: There were 3 cases (27.2%) died in hospital and the remaining 8 cases (72.8%) were found dead at home and were later brought in dead to the hospital. A full autopsy was carried out for each case. Autopsy findings, as well as lab results pertaining to cases that survived and directly brought in dead, were of a different spectrum.
CONCLUSION: Methanol related deaths are almost always as a result of greed. The running truism is 'methanol poisoning is a result of deliberate addition/adulteration with industrial methanol'. Prevention of the illegal production of methanol and methylated spirits should be established to curb this matter in the future.

Filters

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links