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Fulltext The craniotomy box: an innovative method of containing hazardous aerosols generated during skull saw use in autopsy on a COVID-19 body

Hasmi AH, Khoo LS, Koo ZP, Suriani MUA, Hamdan AN, Yaro SWM, et al.

Forensic Sci Med Pathol, 2020 09;16(3):477-480.
PMID: 32500339 DOI: 10.1007/s12024-020-00270-z

During a disease pandemic, there is still a requirement to perform postmortem examinations within the context of legal considerations. The management of the dead from COVID-19 should not impede the medicolegal investigation of the death where required by the authorities and legislation but additional health and safety precautions should be adopted for the necessary postmortem procedures. The authors have therefore used the craniotomy box in an innovative way to enable a safe alternative for skull and brain removal procedures on suspected or confirmed COVID-19 bodies. The craniotomy box technique was tested on a confirmed COVID-19 positive body where a full postmortem examination was performed by a team of highly trained personnel in a negative pressure Biosafety Level 3 (BSL-3) autopsy suite in the National Institute of Forensic Medicine (IPFN) Malaysia. This craniotomy box is a custom-made transparent plastic box with five walls but without a floor. Two circular holes were made in one wall for the placement of arms in order to perform the skull opening procedure. A swab to detect the presence of the SARS-CoV-2 virus was taken from the interior surface of the craniotomy box after the procedure. The result from the test using real-time reverse transcriptase polymerase chain reaction (rRT-PCR) proved that an additional barrier provided respiratory protection by containing the aerosols generated from the skull opening procedure. This innovation ensures procedures performed inside this craniotomy box are safe for postmortem personnel performing high risk autopsies during pandemics.

Matched MeSH terms: Autopsy
Death by 'ice': fatal methamphetamine intoxication of a body packer case detected by postmortem computed tomography (PMCT) and validated by autopsy

Bin Abdul Rashid SN, Rahim AS, Thali MJ, Flach PM

Forensic Sci Med Pathol, 2013 Mar;9(1):82-7.
PMID: 23404531 DOI: 10.1007/s12024-012-9395-1

Fatal acute methamphetamine (MA) poisoning in cases of internal drug trafficking is rarely described in the literature. This case study reports an MA 'body packer' who died from fatal methamphetamine intoxication due to leaking drug packages in the alimentary tract. The deceased was examined by postmortem computed tomography (PMCT), and the results were correlated to subsequent autopsy and toxicological findings. The deceased was arrested by the police when he was found disoriented in the city of Kuala Lumpur. He was transferred to the emergency department on suspicion of drug abuse. The initial drug screening was reactive for amphetamines. Shortly after admission to the hospital, he died despite rigorous resuscitation attempts. The postmortem plain chest and abdominal radiographs revealed multiple suspicious opacities in the gastrointestinal tract attributable to body packages. An unenhanced whole body PMCT revealed twenty-five drug packages, twenty-four in the stomach and one in the transverse colon. At least two were disintegrating, and therefore leaking. The autopsy findings were consistent with the PMCT results. Toxicology confirmed the diagnosis of fatal methamphetamine intoxication.

Matched MeSH terms: Autopsy
Diverticular disease of the large bowel in Singapore. An autopsy survey

Lee YS

Dis Colon Rectum, 1986 May;29(5):330-5.
PMID: 3084185

One thousand fourteen consecutive large intestines were removed at autopsy from persons over the age of 14 years and examined for diverticular disease. Diverticulosis was encountered in 194 patients (19 percent). The lesion appeared early in life, after the second decade. Men were affected more frequently than women before the age of 60 years. Chinese men had significantly more diverticular disease than Malayan men (P less than 0.01) and Indian men (P less than 0.02). Chinese men also had significantly more diverticular disease than Chinese women. There was a predominance of right colon involvement, with the disease affecting especially the ascending colon and cecum. This pattern was observed in all three major ethnic groups, and in both the Singapore-born and foreign-born Singaporeans. The cause of right-sided diverticulosis is unknown. It appears that, while adoption of the western diet may influence the prevalence of diverticular disease, the site of predilection is determined more by racial or genetic predisposition. All diverticula examined histologically were false, including 39 (20 percent) solitary diverticula. The distribution of solitary diverticula was similar to that of multiple diverticulosis. It is suggested that solitary and multiple diverticulosis are part of the spectrum of the same disease.

Matched MeSH terms: Autopsy
Biofilm is associated with chronic streptococcal meningoencephalitis in fish

Isiaku AI, Sabri MY, Ina-Salwany MY, Hassan MD, Tanko PN, Bello MB

Microb Pathog, 2017 Jan;102:59-68.
PMID: 27890651 DOI: 10.1016/j.micpath.2016.10.029

Biofilms are aggregates of attached microbial organisms whose existence on tissues is often recognised as a mechanism for the establishment of most chronic diseases. Herein we investigated the ability of piscine Streptococcus agalactiae, an important aquatic pathogen, for adaptation to this sessile lifestyle in vitro and in the brain of a tilapia fish model. Piscine S. agalactiae exhibited a weak attachment to polystyrene plates and expressed a low biofilm phenotype under the study conditions. Furthermore, fluorescent in situ hybridization and confocal laser scanning microscopy revealed discrete aggregates of attached S. agalactiae within brain tissues and around meningeal surfaces. They were embedded in an exopolysaccharide containing matrix, intractable to inflammatory response and showed some level of resistance to penicillin despite proven susceptibility on sensitivity test. Intracellular bacterial aggregates were also observed, moreover, antibody mediated response was not demonstrated during infection. Nucleated erythrocytes appear to facilitate brain invasion possibly via the Trojan horse mechanism leading to a granulomatous inflammation. We have demonstrated that biofilm is associated with persistence of S. agalactiae and the development of chronic meningoencephalitis in fish.

Matched MeSH terms: Autopsy
Fulltext Management of the dead during COVID-19 outbreak in Malaysia

Khoo LS, Hasmi AH, Ibrahim MA, Mahmood MS

Forensic Sci Med Pathol, 2020 09;16(3):463-470.
PMID: 32519316 DOI: 10.1007/s12024-020-00269-6

The emergence of a novel human coronavirus, SARS-CoV-2, causing severe respiratory tract infections in humans, is affecting all countries of the world and has become a global health concern. Since the virus was first identified in December 2019, the number of deaths have been propagating exponentially, causing countries across the world, including Malaysia, to increase emergency measures to combat the virus. Due to the fact that the COVID-19 pandemic does not discriminate its victims, it is of paramount importance to construct a plan for management of the dead for all suspected or confirmed COVID-19 cases, including the unidentified deceased, as an essential portion of the humanitarian forensic action approach. This document provides an overview on ways to maximize the local collective capacity from various government agencies to manage the dead based on the prevailing regulations and legislation in the country, in preparation for possible large scale deaths from this pandemic. The National Institute of Forensic Medicine Malaysia has improvised procedures and guidelines for management of the dead within the existing regulations in order to achieve a balance between medicolegal requirements and the safety of personnel managing the bodies of the deceased with suspected or confirmed COVID-19 infection; at the site of death, during transport, during postmortem procedures, storage and preparation before and during burial or cremation as well as environmental cleaning and disinfection, involving various agencies in the country. A form of temporary controlled burial is as an option to allow the reinvestigation of a decedent to help formally identify victims of the pandemic such as undocumented migrants or refugees who were previously not identified. Due to the different legal requirements and mortality rates between countries, there is no one-size-fits-all approach to the management of the dead. Whenever possible, every opportunity and assistance must be given to families to mourn their loved ones, even in times of crisis or an outbreak, in order to sustain an appropriate level of dignity and respect.

Matched MeSH terms: Autopsy
Fulltext Non-accidental fatal head injury in small children--a clinico-pathological correlation

Nooraudah AR, Mohd Sham K, Zahari N, Fauziah K

Med J Malaysia, 2004 Jun;59(2):160-5.
PMID: 15559164

Non-accidental head injury leading to massive intracranial trauma has been identified as a leading cause of death in small children. In a typical case, a child usually below the age of one year is violently shaken, leading to rupture of the connecting veins between the dura mater and the brain substance with variable degrees of bleeding into the subdural space resulting in increased intracranial pressure. The accompanying venous thrombosis affecting the vessels of the brain substance leads to cerebral hypoxia and cellular death. In this study conducted throughout the year 1999, all children below the age of 3 years who were admitted to Hospital Kuala Lumpur and had died due to non-accidental injuries were included. Postmortems, including histopathological studies, were conducted to determine the most likely mechanisms of the injuries. Ten cases were identified for the whole year. In 2 cases, both below one year of age, the features presented showed evidence of violent shaking of the infants. In 6 other cases whose average age was 13 (range 4-24) months, there were evidences of direct trauma and violent shaking. In the last two cases, aged 24 and 33 months respectively, there was only evidence of direct trauma on the heads without being shaken. This study shows that death due to intracranial trauma caused by shaking with or without direct impact is the most frequent cause of mortality in abused children. Death due to direct impact between the head and another object is a less frequent occurrence.

Matched MeSH terms: Autopsy
Cardiac sarcoidosis: two cases with autopsy findings

Wan Muhaizan WM, Swaminathan M, Daud MS

Malays J Pathol, 2004 Jun;26(1):59-63.
PMID: 16196153

Cardiac sarcoidosis is a disease of young adults. In most cases it presents with sudden death, arrhythmias, conduction disorders, heart failure or cardiomyopathy. The authors describe two cases of myocardial involvement by sarcoidosis that lead to death of the patients. Case one was a 26-year-old Indian man who was previously well and presented with sudden death. Autopsy showed nodules of sarcoid granuloma involving the heart, lungs and lymph nodes. Case two was a 47-year-old Indian lady who complained of reduced effort tolerance. Echocardiography showed that she had restrictive hypertrophic cardiomyopathy with heart failure. Seven months after initial presentation, she developed worsening of heart failure and died. Autopsy revealed involvement of the heart, lungs and liver by sarcoidosis.

Matched MeSH terms: Autopsy
Fulltext Influence of Diet and Postmortem Ageing on Oxidative Stability of Lipids, Myoglobin and Myofibrillar Proteins and Quality Attributes of Gluteus Medius Muscle in Goats

Adeyemi KD, Shittu RM, Sabow AB, Ebrahimi M, Sazili AQ

PLoS One, 2016;11(5):e0154603.
PMID: 27138001 DOI: 10.1371/journal.pone.0154603

This study appraised the effects of dietary blend of 80% canola oil and 20% palm oil and postmortem ageing on oxidative stability, fatty acids and quality attributes of gluteus medius (GM) muscle in goats. Twenty-four Boer bucks were randomly allotted to diet supplemented with 0, 4 and 8% oil blend, fed for 100 days and slaughtered, and the GM muscle was subjected to a 7 d chill storage (4±1°C). Diet had no effect (P> 0.05) on the colour, drip loss, thiobarbituric acid-reactive substances (TBARS) value, free thiol, carbonyl, myoglobin and metmyoglobin contents, metmyoglobin reducing activity (MRA), antioxidant enzyme activities and abundance of myosin heavy chain (MHC) and actin in the GM muscle in goats. The meat from goats fed 4 and 8% oil blend had higher (P< 0.05) concentration of α and γ-tocopherol and abundance of troponin T compared with that from the control goats. The GM muscle from the oil-supplemented goats had lower (P< 0.05) concentration of C16:0 and greater (P< 0.05) concentration of C18:1n-9, C18:3n-3 and C20:5n-3 compared with that from the control goats. Nonetheless, diet did not affect (P< 0.05) the total fatty acid in the GM muscle in goats. Regardless of the diet, the free thiol and myoglobin contents, concentration of tocopherol and total carotenoids, MHC and MRA in the GM muscle decreased (P< 0.05) while carbonyl content, TBARS, drip loss and metmyoglobin content increased over storage. Dietary blend of 80% canola oil and 20% palm oil beneficially altered tissue lipids without hampering the oxidative stability of chevon.

Matched MeSH terms: Autopsy
Aortic and coronary atherosclerosis in the Malaysian Orang Asli

Prathap K, Montgomery GL

Pathology, 1974 Jul;6(3):255-61.
PMID: 4412062
Matched MeSH terms: Autopsy
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.

Matched MeSH terms: Autopsy
Clinico-pathology and hemato-biochemistry responses in buffaloes infected with Pasteurella multocida type B:2 immunogen outer membrane protein

Chung ELT, Abdullah FFJ, Marza AD, Saleh WMM, Ibrahim HH, Abba Y, et al.

Microb Pathog, 2017 Jan;102:89-101.
PMID: 27894962 DOI: 10.1016/j.micpath.2016.11.015

The aim of this study was to investigate the clinico-pathology and haemato-biochemistry alterations in buffaloes inoculated with Pasteurella multocida type B:2 immunogen outer membrane protein via subcutaneous and oral routes. Nine buffalo heifers were divided equally into 3 treatment groups. Group 1 was inoculated orally with 10 mL of phosphate buffer saline (PBS); Group 2 and 3 were inoculated with 10 mL of outer membrane protein broth subcutaneously and orally respectively. Group 2 buffaloes showed typical haemorrhagic septicaemia clinical signs and were only able to survive for 72 h of the experiment. However, Group 3 buffaloes were able to survive throughout the stipulated time of 21 days of experiment. There were significant differences (p 0.05) in edema between groups except for the lung. This study was a proof that oral route infection of Pasteurella multocida type B:2 immunogen outer membrane protein can be used to stimulate host cell.

Matched MeSH terms: Autopsy
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.

Matched MeSH terms: Autopsy
Islamic medical jurisprudence syllabus: A Review in Saudi Arabia

Chamsi-Pasha H, Albar MA

Med J Malaysia, 2017 10;72(5):278-281.
PMID: 29197882

INTRODUCTION: The ever-increasing technological advances of Western medicine have created new ethical issues awaiting answers and response. The use of genetic therapy, organ transplant, milk-banking, end-of-life care and euthanasia are of paramount importance to the medical students and need to be addressed.
METHODS: A series of searches were conducted of Medline databases published in English between January 2000 and January 2017 with the following keywords: medical ethics, syllabus, Islam, jurisprudence.
RESULTS: Islamic medical jurisprudence is gaining more attention in some medical schools. However, there is still lack of an organised syllabus in many medical colleges.
CONCLUSION: The outlines of a syllabus in Islamic medical jurisprudence including Islamic values and moral principles related to both the practice and research of medicine are explored.

Matched MeSH terms: Autopsy
Fulltext Pattern of homicidal deaths autopsied at Penang Hospital, Malaysia, 2007-2009: a preliminary study

Bhupinder S, Kumara TK, Syed AM

Malays J Pathol, 2010 Dec;32(2):81-6.
PMID: 21329178 MyJurnal

This article describes the homicide pattern in Penang Island, Malaysia over a three-year period (2007-2009). 65 homicide autopsies were performed at the Department of Forensic Medicine, Penang Hospital over the study period. The homicide rates ranged from 0.01 to 0.09/1000 population, the highest being in the Indian ethnic group. The majority (37%) of victims were in the 20-39 years age group. The male: female ratio was 3:1. The majority of deaths were caused by blunt instruments (46%), followed by stab/slash wounds (25%) and asphyxiation (12%). 63% of homicides occurred in areas served by the police stations at Jalan Patani (23.1%), Sg. Nibong (16.9%), Central (12.3%) and Bayan Lepas (10.9%). 56 (86%) victims were brought in dead to the hospital, while 9 (14%) died after admission. Most (39%) incidences occurred in the morning. The methods of homicide were different from Kuala Lumpur, another highly urbanised area of Malaysia.

Matched MeSH terms: Autopsy
Microwave-stimulated formaldehyde fixation of experimental renal biopsy tissues: computerised morphometric analysis of distortion artefacts

Looi LM, Loh KC

Malays J Pathol, 2005 Jun;27(1):23-7.
PMID: 16676689

Although microwave irradiation has been used in the histopathology laboratory for several years, there has been minimal published experimental data on its effects on the technical and staining quality of histological sections. Furthermore, it has not been clear whether the advantages gained in reduction of fixation and staining duration has been at the expense of increasing architectural distortion to the tissues. We report here our experience with computerised morphometric analysis to investigate glomerular artifacts caused by microwave-stimulated fixation of renal tissues. 39 rat and 33 human autopsy kidney samples were subjected to (1) fixation in neutral buffered formaldehyde (control), (2) microwave-stimulated fixation followed by neutral buffered formaldehyde, and (3) neutral buffered formaldehyde followed by microwave irradiation. In addition, the effect of post-fixation in 70% ethanol was also investigated. Microwave irradiation was delivered through a dedicated laboratory microwave oven at 80% power and at 55 degrees C for 3 minutes. The different fixation methods were compared with regards to shrinkage (distortion) to glomerular structures (glomeruli and Bowman's spaces) on H and E sections, as determined by morphometric image analysis using a temporary assembled-system consisting of a trinocular microscope, a digital video camera and personal computer. A FlashPoint VGA 3.3 film-grabber card was used to capture images for morphometric analysis by using a Scion Image program. Morphometric analysis of glomerular structures showed that microwaves caused more shrinkage to the area bounded by the Bowman's capsule than the glomerulus proper, but post-fixation with ethanol reduced this shrinkage. These findings have implications on the logistics of tissue preparation of renal biopsies in clinical practice.

Matched MeSH terms: Autopsy
Microscopic studies on postmortem vermiform appendix of the adult males of Bangladesh

Bakar SM, Shamim M, Salam A, Sultana SA

Ir J Med Sci, 2016 Feb;185(1):249-57.
PMID: 25894278 DOI: 10.1007/s11845-015-1287-4

BACKGROUND: The anatomy of the vermiform appendix shows variations in its macroscopic dimensions and microscopic features, some of which have potentials of influencing the clinical aspects of the appendix.
AIM: The aim of this study was to find out some microscopic features of appendix and evaluate the correlation between the microscopic features of the appendix and the age of the subjects and to determine whether these findings should influence the clinical implications of appendix.
METHODS: In this cross-sectional observational study, thirty adult males' (age from 18 to 67 years) postmortem appendices and adnexa from Bangladeshi victims of road traffic accidents were sectioned at the base, midzone and tip stained with H+E stain and examined under microscope. Measurements were taken at the base, at the midzone and at the tip of the appendix, and the mean of the three measurements was considered as the overall value.
RESULTS: The overall number of mucosal glands in a section ranged from 42.33 to 130.00 and the number of the germinal centres varied between 2.33 and 10.00. The overall luminal diameter ranged between 1764.58 and 3208.33 µm. The overall luminal diameter in more than 52 % of cases was between 2700.00 and 3299.99 µm with a median value of 2750 µm.
CONCLUSION: The overall number of mucosal glands showed a tendency towards a positive correlation with age. The overall luminal diameter and the overall number of germinal centres showed a tendency towards a negative correlation with the age. However, none of the tendencies of correlation reached statistically any significant level.

Matched MeSH terms: Autopsy
Capgras syndrome in a very late onset, treatment resistant schizophrenia

Ain MK, Rosdinom R, Raynuha M

Int Psychogeriatr, 2015 Sep;27(9):1573-5.
PMID: 25794136 DOI: 10.1017/S1041610215000332

We report a Malay man, with underlying chronic medical illnesses, presenting with positive symptoms of schizophrenia, including Capgras syndrome (CS) at the age of 73. Physical examination and blood investigations were normal and brain CT scan showed age-related cerebral atrophy. Neuropsychological assessment showed probable right hemisphere lesions but relatively intact memory and intellectual functions. Several neuroleptics including depot injections were tried but ineffective. Positive symptoms including CS eventually improved with clozapine before his death from myocardial infarction. This case report highlights the uncommon occurrence of CS in treatment resistant schizophrenia (TRS) of very late onset and its treatment challenges.

Matched MeSH terms: Autopsy
Murder and robbery by vehicular impact: true vehicular homicide

Nadesan K

Am J Forensic Med Pathol, 2000 Jun;21(2):107-13.
PMID: 10871122

True vehicular homicides are defined as those occurrences in which a motor vehicle is intentionally used as a weapon in taking of a life. A case is presented in which the deceased was traveling in the front passenger seat of a motor car that was deliberately rammed by a heavy jeep that came in the opposite direction, resulting in a serious frontal collision. Immediately after the impact, while the occupants of the car were lying in a dazed condition, the two persons riding in the jeep escaped with a bag containing money that was in the car, leaving the jeep behind. The impact mainly involved the driver's sides of both vehicles. The driver of the car sustained serious injuries but was found to be alive, whereas the front-seat passenger, who did not show any serious external injuries, was found to be in a collapsed state and was pronounced dead on admission to the hospital within 30 minutes of the accident. The autopsy revealed that death was caused by closed hemopericardium from a ruptured right atrium. The evaluation of the external and internal injuries confirmed that the fatal injury and a few serious internal injuries were caused by the seat belt (tertiary-impact injuries). The ruptured right atrium was attributed to blunt abdominal trauma by impacting against the lap belt. The case was a true vehicular homicide in which a motor vehicle had been used as a weapon to kill a person. Various aspects pertaining to road accidents, the safety of the occupants, and the advantage and disadvantage of the safety devices are discussed.

Matched MeSH terms: Autopsy
Pattern of suicide: a review of autopsies conducted at the University Hospital, Kuala Lumpur

Nadesan K

Malays J Pathol, 1999 Dec;21(2):95-9.
PMID: 11068413

Suicide is one of the ten leading causes of death in the world, accounting for more than 400,000 deaths annually. The pattern of suicide and the incidence of suicide vary from country to country. Cultural, religious and social values play some role in suicide. Compared to the West and some of the countries in the Asian region the incidence of suicide is low in Malaysia. A three-year retrospective study of all the autopsies performed at the University Hospital, Kuala Lumpur was analysed and the cases that were definitely determined as suicides were further studied. 48.8% of all suicides were ethnic Indians though Indians formed only 8% of the Malaysian population. 38.1% of suicides were Chinese who formed 26% of the population while only 3.6% were Malays, who formed 59% of the population. The preferred methods of suicide were poisoning and hanging. The majority were in the age group 20-40 yr. The study may have missed some cases that would have been wrongly concluded as accidental deaths and a few others where the police would have released the bodies without postmortem examinations.

Matched MeSH terms: Autopsy
Impact of saturated and trans fatty acid enriched oil blends on atherosclerosis in rabbits fed cholesterol-free diets

Sundram K, Pathmanathan R, Wong KT, Baskaran G

Asia Pac J Clin Nutr, 1997 Mar;6(1):31-5.
PMID: 24394650

Thirty six-male New Zealand White rabbits subdivided into four dietary groups (9 animals per group) were fed high fat (36% en), cholesterol-free diets for nine months. The dietary oil blends were formulated to contain high levels of the target fatty acids namely trans-rich (partially hydrogenated soybean oil; TRANS), cis monounsaturated-rich (rapeseed, sunflower seed oil and palm olein; MONO), palmitic-rich (palm olein; POL) and lauric-myristic rich (coconut, palm kernel and corn oils; LM). Ad libitum feeding of the rabbits resulted in normal growth throughout the nine months and no differences in the final body weights of the animals were evident at autopsy. Plasma total cholesterol was significantly elevated only by the LM enriched diet compared with all other treatments; values were comparable between the other three treatment groups. Changes in the total cholesterol were not reflected in the VLDL and LDL lipoproteins. However, HDL-cholesterol was significantly lowered by the TRANS diet compared with all other dietary groups. HDL-cholesterol was also significantly increased by the LM diet in comparison to the POL-diet. Both adipose and liver triglyceride fatty acid compositions tended to reflect the type of fatty acids fed the animals. Trans fatty acids were evident only in animals fed the trans diet and it was apparent that the trans fatty acids competed with linoleic acid for incorporation into these tissues. Increased concentrations of lauric and myristic fatty acids in the LM-fed animals were also evident. In the POL and high MONO fed rabbits, palmitic and oleic fatty acids (respectively) were concentrated in the adipose and liver. The diets, however, failed to induce severe atherosclerosis in this study. This can be explained, in part, by the lack of dietary cholesterol and the use of plant (rather than animal) proteins in our dietary formulations. The effect of these important atherosclerosis modulators in association with these fatty acids requires further evaluation.

Matched MeSH terms: Autopsy

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