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  1. Fulltext 2020 Consensus summary on the management of hypertension in Asia from the HOPE Asia Network
    Kario K, Park S, Chia YC, Sukonthasarn A, Turana Y, Shin J, et al.
    J Clin Hypertens (Greenwich), 2020 03;22(3):351-362.
    PMID: 31816164 DOI: 10.1111/jch.13751
    Hypertension professionals from Asia have been meeting together for the last decade to discuss how to improve the management of hypertension. Based on these education and research activities, the Hypertension, brain, cardiovascular and renal Outcome Prevention and Evidence in Asia (HOPE Asia) Network was officially established in June 2018 and includes experts from 12 countries/regions across Asia. Among the numerous research and review papers published by members of the HOPE Asia Network since 2017, publications in three key areas provide important guidance on the management of hypertension in Asia. This article highlights key consensus documents, which relate to the Asian characteristics of hypertension, home blood pressure monitoring (HBPM), and ambulatory blood pressure monitoring (ABPM). Hypertension and hypertension-related diseases are common in Asia, and their characteristics differ from those in other populations. It is essential that these are taken into consideration to provide the best opportunity for achieving "perfect 24-hour blood pressure control", guided by out-of-office (home and ambulatory) blood pressure monitoring. These region-specific consensus documents should contribute to optimizing individual and population-based hypertension management strategies in Asian country. In addition, the HOPE Asia Network model provides a good example of the local interpretation, modification, and dissemination of international best practice to benefit specific populations.
    Matched MeSH terms: Blood Pressure; Blood Pressure Monitoring, Ambulatory*
  2. Fulltext A Pharmacological Examination of the Cardiovascular Effects of Malayan Krait (Bungarus candidus) Venoms
    Chaisakul J, Rusmili MR, Hodgson WC, Hatthachote P, Suwan K, Inchan A, et al.
    Toxins (Basel), 2017 03 29;9(4).
    PMID: 28353659 DOI: 10.3390/toxins9040122
    Cardiovascular effects (e.g., tachycardia, hypo- and/or hypertension) are often clinical outcomes of snake envenoming. Malayan krait (Bungarus candidus) envenoming has been reported to cause cardiovascular effects that may be related to abnormalities in parasympathetic activity. However, the exact mechanism for this effect has yet to be determined. In the present study, we investigated thein vivoandin vitrocardiovascular effects ofB. candidusvenoms from Southern (BC-S) and Northeastern (BC-NE) Thailand. SDS-PAGE analysis of venoms showed some differences in the protein profile of the venoms.B. candidusvenoms (50 µg/kg-100 µg/kg, i.v.) caused dose-dependent hypotension in anaesthetised rats. The highest dose caused sudden hypotension (phase I) followed by a return of mean arterial pressure to baseline levels and a decrease in heart rate with transient hypertension (phase II) prior to a small decrease in blood pressure (phase III). Prior administration of monovalent antivenom significantly attenuated the hypotension induced by venoms (100 µg/kg, i.v.). The sudden hypotensive effect of BC-NE venom was abolished by prior administration of hexamethonium (10 mg/kg, i.v.) or atropine (5 mg/kg, i.v.). BC-S and BC-NE venoms (0.1 µg/kg-100 µg/ml) induced concentration-dependent relaxation (EC50= 8 ± 1 and 13 ± 3 µg/mL, respectively) in endothelium-intact aorta. The concentration-response curves were markedly shifted to the right by pre-incubation with L-NAME (0.2 mM), or removal of the endothelium, suggesting that endothelium-derived nitric oxide (NO) is likely to be responsible for venom-induced aortic relaxation. Our data indicate that the cardiovascular effects caused byB. candidusvenoms may be due to a combination of vascular mediators (i.e., NO) and autonomic adaptation via nicotinic and muscarinic acetylcholine receptors.
    Matched MeSH terms: Blood Pressure/drug effects
  3. A Proposed Pediatric Clinical Cardiovascular Health Reference Standard
    Petito LC, McCabe ME, Pool LR, Krefman AE, Perak AM, Marino BS, et al.
    Am J Prev Med, 2024 Feb;66(2):216-225.
    PMID: 37751803 DOI: 10.1016/j.amepre.2023.09.019
    INTRODUCTION: Clinical cardiovascular health is a construct that includes 4 health factors-systolic and diastolic blood pressure, fasting glucose, total cholesterol, and body mass index-which together provide an evidence-based, more holistic view of cardiovascular health risk in adults than each component separately. Currently, no pediatric version of this construct exists. This study sought to develop sex-specific charts of clinical cardiovascular health for age to describe current patterns of clinical cardiovascular health throughout childhood.

    METHODS: Data were used from children and adolescents aged 8-19 years in six pooled childhood cohorts (19,261 participants, collected between 1972 and 2010) to create reference standards for fasting glucose and total cholesterol. Using the models for glucose and cholesterol as well as previously published reference standards for body mass index and blood pressure, clinical cardiovascular health charts were developed. All models were estimated using sex-specific random-effects linear regression, and modeling was performed during 2020-2022.

    RESULTS: Models were created to generate charts with smoothed means, percentiles, and standard deviations of clinical cardiovascular health for each year of childhood. For example, a 10-year-old girl with a body mass index of 16 kg/m2 (30th percentile), blood pressure of 100/60 mm Hg (46th/50th), glucose of 80 mg/dL (31st), and total cholesterol of 160 mg/dL (46th) (lower implies better) would have a clinical cardiovascular health percentile of 62 (higher implies better).

    CONCLUSIONS: Clinical cardiovascular health charts based on pediatric data offer a standardized approach to express clinical cardiovascular health as an age- and sex-standardized percentile for clinicians to assess cardiovascular health in childhood to consider preventive approaches at early ages and proactively optimize lifetime trajectories of cardiovascular health.

    Matched MeSH terms: Blood Pressure/physiology
  4. Fulltext A Review on the Protective Effects of Honey against Metabolic Syndrome
    Ramli NZ, Chin KY, Zarkasi KA, Ahmad F
    Nutrients, 2018 Aug 02;10(8).
    PMID: 30072671 DOI: 10.3390/nu10081009
    Metabolic syndrome (MetS) is a cluster of diseases comprising of obesity, diabetes mellitus, dyslipidemia, and hypertension. There are numerous pre-clinical as well as human studies reporting the protective effects of honey against MetS. Honey is a nutritional food low in glycemic index. Honey intake reduces blood sugar levels and prevents excessive weight gain. It also improves lipid metabolism by reducing total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL) and increasing high-density lipoprotein (HDL), which leads to decreased risk of atherogenesis. In addition, honey enhances insulin sensitivity that further stabilizes blood glucose levels and protects the pancreas from overstimulation brought on by insulin resistance. Furthermore, antioxidative properties of honey help in reducing oxidative stress, which is one of the central mechanisms in MetS. Lastly, honey protects the vasculature from endothelial dysfunction and remodelling. Therefore, there is a strong potential for honey supplementation to be integrated into the management of MetS, both as preventive as well as adjunct therapeutic agents.
    Matched MeSH terms: Blood Pressure
  5. Fulltext A Shallow U-Net Architecture for Reliably Predicting Blood Pressure (BP) from Photoplethysmogram (PPG) and Electrocardiogram (ECG) Signals
    Mahmud S, Ibtehaz N, Khandakar A, Tahir AM, Rahman T, Islam KR, et al.
    Sensors (Basel), 2022 Jan 25;22(3).
    PMID: 35161664 DOI: 10.3390/s22030919
    Cardiovascular diseases are the most common causes of death around the world. To detect and treat heart-related diseases, continuous blood pressure (BP) monitoring along with many other parameters are required. Several invasive and non-invasive methods have been developed for this purpose. Most existing methods used in hospitals for continuous monitoring of BP are invasive. On the contrary, cuff-based BP monitoring methods, which can predict systolic blood pressure (SBP) and diastolic blood pressure (DBP), cannot be used for continuous monitoring. Several studies attempted to predict BP from non-invasively collectible signals such as photoplethysmograms (PPG) and electrocardiograms (ECG), which can be used for continuous monitoring. In this study, we explored the applicability of autoencoders in predicting BP from PPG and ECG signals. The investigation was carried out on 12,000 instances of 942 patients of the MIMIC-II dataset, and it was found that a very shallow, one-dimensional autoencoder can extract the relevant features to predict the SBP and DBP with state-of-the-art performance on a very large dataset. An independent test set from a portion of the MIMIC-II dataset provided a mean absolute error (MAE) of 2.333 and 0.713 for SBP and DBP, respectively. On an external dataset of 40 subjects, the model trained on the MIMIC-II dataset provided an MAE of 2.728 and 1.166 for SBP and DBP, respectively. For both the cases, the results met British Hypertension Society (BHS) Grade A and surpassed the studies from the current literature.
    Matched MeSH terms: Blood Pressure; Blood Pressure Determination
  6. Fulltext A Study on the Nutritional Status of Physically Active Men in Kota Bharu
    Malays J Nutr, 2003;9(2):-.
    MyJurnal
    A cross-sectional comparative study was conducted to determine the nutritional status among physically active groups in Kota Bharu. The study population comprised 83 adult male athletes from 8 different types of sports (athlete group), 80 active men who exercised a minimum of 30 min per day for at least 3 times per week (exercise group), and 80 inactive men (sedentary group). All the respondents were aged between 18 to 44 years. Measurements taken from the respondents were anthropometric measurements, systolic (SBP) and diastolic (DBP) blood pressure, and serum total cholesterol (TC). The results showed that the combined prevalence of pre-obese (BMI 25.0-29.9) and obese (BMI ¡Ý30.0) was 21.7% in athletes, 29.9% in exercise group, and 47.5% in sedentary group. The mean (± SD) percentage of body fat in athletes was 15.7 ± 5.4%, which was lower compared to the exercise (18.9 ± 5.5%) and sedentary (20.6 ± 5.8%) groups. The incidence of waist-to-hip ratio above 0.9 in athlete, exercise and sedentary groups was 9.6%, 18.7% and 31.3%, respectively. The incidence of hypertension (SBP ¡Ý140 and/or DBP ¡Ý90 mmHg) was 13.2% in athletes, 17.5% in exercise group and 42.5% in the sedentary group. The TC values showed that the prevalence of “high risk” individuals (TC ¡Ý6.20 mmol/l) was also lower in athletes (20.5%), compared to the exercise (36.2%) and sedentary (47.5%) groups. The study revealed that individuals who are actively involved in physical activity, particularly in sport activities have better nutritional status compared to sedentary people. However, the nutritional status in the athlete and exercise groups was still unsatisfactory. The incidence of poor health status related to over nutrition in the active groups was rather high and needs attention from health professionals. Further studies are needed to determine nutritional practices among physically active groups.
    Matched MeSH terms: Blood Pressure; Blood Pressure Determination
  7. Fulltext A blood pressure profile of rural Kadazans and Bajaus in Sabah, east Malaysia
    Gan CY, Chan MK
    Southeast Asian J. Trop. Med. Public Health, 1993 Sep;24(3):583-9.
    PMID: 8160073
    A survey was conducted to document the blood pressures of two indigenous groups (Kadazans and Bajaus) who reside in rural Sabah in East Malaysia. Their health knowledge status is also recorded. Fifty percent of those surveyed were unable to associate high blood pressure with a risk factor and as high as 38% were unaware of the consequences of high blood pressure. A total of 16.2% had blood pressures > or = 140/or 90mm Hg while 3.9% had blood pressures > or = 160/or 95mm Hg. While these figures are low compared to those of developed countries, lifestyle changes associated with rapid urbanization in Malaysia may be expected to increase hypertension prevalence. The strengthening of health education programs is timely as health knowledge is limited and many hypertensives default treatment.
    Matched MeSH terms: Blood Pressure
  8. A brief review of the diabetes mellitus, heart disease and blood pressure studies
    Loncin H
    Med J Malaya, 1965 Jun;19(4):321-3.
    PMID: 4220862
    Matched MeSH terms: Blood Pressure*
  9. Fulltext A brief review on ACE I/D gene polymorphism and blood pressure response to exercise training
    Hazwani Ahmad Yusof, Abdul Rashid Aziz, Nor Farah Mohamad Fauzi, Ahmad Munir Che Muhamed
    Malaysian Journal of Medicine and Health Sciences, 2018;14(201):179-189.
    MyJurnal
    Exercise has been suggested as the best and the most affordable way for managing blood pressure. The insertion/ deletion of angiotensin I-converting enzyme (ACE) I/D gene polymorphism had been reported to be linked with sev- eral diseases such as hypertension and diabetic nephropathy. Several studies showed that blood pressure response to exercise training for health management also vary among individuals with different genotypes of ACE I/D gene poly- morphism. A study of 9 months of endurance exercise training at 75 to 85 % of VO2max showed that the decrease of resting blood pressure in I allele carriers wass greater than D allele carriers. In contrast, other study discovered that adult women with D allele had greater reduction in resting blood pressure than those with I allele, following a 12-week combined aerobic and resistance exercise training. Despite the inconsistencies of some findings, it has remained unknown if the ACE I/D gene polymorphism would also influence blood pressure response to isometric handgrip training that had been found to be superior to the dynamic resistance exercise training in controlling and preventing high blood pressure. Thus, this article was to review the literature on ACE I/D gene polymorphism and blood pressure response to exercise training that could serve as the basis for future research to identify individuals who will lower resting blood pressure the most with exercise training program for health management.
    Matched MeSH terms: Blood Pressure
  10. Fulltext A cardiovascular mathematical model of graded head-up tilt
    Lim E, Chan GS, Dokos S, Ng SC, Latif LA, Vandenberghe S, et al.
    PLoS One, 2013;8(10):e77357.
    PMID: 24204817 DOI: 10.1371/journal.pone.0077357
    A lumped parameter model of the cardiovascular system has been developed and optimized using experimental data obtained from 13 healthy subjects during graded head-up tilt (HUT) from the supine position to [Formula: see text]. The model includes descriptions of the left and right heart, direct ventricular interaction through the septum and pericardium, the systemic and pulmonary circulations, nonlinear pressure volume relationship of the lower body compartment, arterial and cardiopulmonary baroreceptors, as well as autoregulatory mechanisms. A number of important features, including the separate effects of arterial and cardiopulmonary baroreflexes, and autoregulation in the lower body, as well as diastolic ventricular interaction through the pericardium have been included and tested for their significance. Furthermore, the individual effect of parameter associated with heart failure, including LV and RV contractility, baseline systemic vascular resistance, pulmonary vascular resistance, total blood volume, LV diastolic stiffness and reflex gain on HUT response have also been investigated. Our fitted model compares favorably with our experimental measurements and published literature at a range of tilt angles, in terms of both global and regional hemodynamic variables. Compared to the normal condition, a simulated congestive heart failure condition produced a blunted response to HUT with regards to the percentage changes in cardiac output, stroke volume, end diastolic volume and effector response (i.e., heart contractility, venous unstressed volume, systemic vascular resistance and heart rate) with progressive tilting.
    Matched MeSH terms: Blood Pressure/physiology
  11. Fulltext A clinical audit on diabetes care in two urban public primary care clinics in Malaysia
    Sazlina SG, Zailinawati AH, Zaiton A, Ong I
    Malaysian Journal of Medicine and Health Sciences, 2010;6(1):101-109.
    MyJurnal
    Introduction: The incidence of diabetes mellitus (DM) is increasing globally and it is associated with significant morbidity and mortality. The importance of a better quality of diabetes care is increasingly acknowledged. Objective: This clinical audit was conducted to assess the quality of care given to type 2 DM patients in public primary care clinics. Methods: A clinical audit was conducted in two selected urban public primary care clinics, between April and June of 2005. The indicators and criteria of quality care were based on the current Malaysian clinical practice guidelines for type 2 DM. A structured pro forma was used to collect data. Results: A total of 396 medical records of patients with type 2 DM were included in this audit. Most of the patients had measurements of fasting blood glucose and blood pressure recorded in more than 90% of the visits over the previous one year. Twenty-seven percent of the patients had glycosylated haemoglobin (HbA1c) done every 6 months with a mean of 8.3%. Only 15.6% had HbA1c values less than 6.5 %. Fifty percent had blood pressure controlled at 130/80 mmHg and below; and 13.0% had low density lipoprotein cholesterol values of 2.6 mmol/L or less. The majority of the patients were overweight or obese. Conclusions: The quality of diabetes care in this study was
    found to be suboptimal. There is a gap between guidelines and clinical practice. Certain measures to improve the quality of diabetes care need to be implemented with more rigour.
    Matched MeSH terms: Blood Pressure; Blood Pressure Determination
  12. Fulltext A community health screening conducted at Sungai Pinang township, state of Pulau Pinang, Malaysia
    Chai Fung Kiew, Chee Ping Chong
    Malaysian Journal of Pharmaceutical Science, 2013;11(1):59-68.
    MyJurnal
    Non-communicable diseases are raising much concern in Malaysia due to changing lifestyles which is parallel to the economic development. Intervention program like community health screening (CHS) allows early detection, prevention and reduction of chronic diseases and its risk factors. This study aimed to assess the obesity level, risk factors for chronic diseases and blood cholesterol level among the Malaysian public. A health screening program was conducted on April 2012 at Sungai Pinang township, in the state of Pulau Pinang, Malaysia. A convenient sample of the general public was recruited. Screening tests consisted of measurements of blood pressure, body mass index (BMI), body fat percentage, visceral fat accumulation (VFA) and blood cholesterol. Chi-square analysis was used to determine the difference between prevalence of obesity among subjects with different age groups and gender. Out of 76 recruited subjects, 23.7% had systolic blood pressure of 140 mmHg or greater and 7.9% had diastolic blood pressure of 90 mmHg or greater. Approximately 51% of the subjects were obese (BMI ≥ 27.5 kg/m2). Body fat percentage was high in 63.6% and 63.0% of male and female subjects, respectively. High VFA (≥15) was found in 19.8% of subjects. There were three newly discovered hypercholesterolemia cases (total cholesterol ≥ 5.2 mmol/L). Counselling was given during the health screening program to help the public to take necessary measures to reduce risk factors while preventing complication resulting from these chronic diseases. In conclusion, prevalence of obesity found to be high in the present screened population.
    Matched MeSH terms: Blood Pressure; Blood Pressure Determination
  13. Fulltext A comparison of the maintenance and recovery charcateristic of sevoflurane-nitrous oxide against isoflurane-nitrous oxide anaesthesia
    Chiu CL, Chan YK, Ong GS, Delilkan AE
    Singapore Med J, 2000 Nov;41(11):530-3.
    PMID: 11284610
    To compare the maintenance and recovery characteristics of sevoflurane and isoflurane anaesthesia in Malaysian patients.
    Matched MeSH terms: Blood Pressure/drug effects
  14. Fulltext A diagnostic workup of perioperative anaphylaxis reveals a selective type 1 hypersensitivity to cefazolin
    Meera Thalayasingam, Shek, Lynette Pei-Chi
    International e-Journal of Science, Medicine & Education, 2015;9(2):37-39.
    MyJurnal
    Anaphylaxis in the operating room although infrequent can be potentially fatal. The diagnosis of perioperative anaphylaxis is complex due to a multitude of factors. Firstly, patients under anesthesia cannot verbalize their complaints, the anesthetic agents themselves can alter vital parameters (e.g. heart rate and blood pressure) and cutaneous signs in a completely draped patient may be missed. Secondly, the differential diagnosis of intraoperative anaphylaxis is wide. Conditions such as asthma exacerbation, arrhythmia, hemorrhage, angioedema, mastocytosis, acute myocardial infarction, drug overdose, pericardial tamponade, pulmonary edema, pulmonary embolus, sepsis, tension pneumothorax, vasovagal reaction, venous air embolism, laryngospasm, blood transfusion reaction and malignant hyperthermia need to be considered. Thirdly, the diagnostic workup is challenging due to the multiple medications administered and other exposures encountered such as latex and chlorhexidene. However, through a timely allergy consultation and a systematic approach, identification of the culprit agent and safe alternatives can be established to prevent future occurrences as illustrated in the case below.
    Matched MeSH terms: Blood Pressure
  15. A method for control of an implantable rotary blood pump for heart failure patients using noninvasive measurements
    Lim E, Alomari AH, Savkin AV, Dokos S, Fraser JF, Timms DL, et al.
    Artif Organs, 2011 Aug;35(8):E174-80.
    PMID: 21843286 DOI: 10.1111/j.1525-1594.2011.01268.x
    We propose a deadbeat controller for the control of pulsatile pump flow (Q(p) ) in an implantable rotary blood pump (IRBP). Noninvasive measurements of pump speed and current are used as inputs to a dynamical model of Q(p) estimation, previously developed and verified in our laboratory. The controller was tested using a lumped parameter model of the cardiovascular system (CVS), in combination with the stable dynamical models of Q(p) and differential pressure (head) estimation for the IRBP. The control algorithm was tested with both constant and sinusoidal reference Q(p) as input to the CVS model. Results showed that the controller was able to track the reference input with minimal error in the presence of model uncertainty. Furthermore, Q(p) was shown to settle to the desired reference value within a finite number of sampling periods. Our results also indicated that counterpulsation yields the minimum left ventricular stroke work, left ventricular end diastolic volume, and aortic pulse pressure, without significantly affecting mean cardiac output and aortic pressure.
    Matched MeSH terms: Blood Pressure
  16. A puzzling case of cardiac arrest
    Hannah HB
    Br J Anaesth, 1971 Oct;43(10):991-3.
    PMID: 5115036
    Matched MeSH terms: Blood Pressure
  17. Fulltext A qualitative exploration of hypertensive patients' perception towards quality use of medication and hypertension management at the community level
    Tan CS, Hassali MA, Neoh CF, Saleem F
    Pharm Pract (Granada), 2017 12 18;15(4):1074.
    PMID: 29317924 DOI: 10.18549/PharmPract.2017.04.1074
    Objective: This study aimed to explore hypertensive patients' perspectives on quality use of medication and issues related to hypertension management at the community level in Malaysia.

    Methods: Focus groups discussion was employed in this qualitative study. A total of 17 hypertensive patients were purposively recruited. Three focus group discussions with semi-structured interview were carried out at Flat Desa Wawasan, Penang. All the conversations were audio recorded, transcribed verbatim and thematically analysed.

    Results: Three major themes were developed, including medication adherence among hypertensive patients, self-management of hypertension and patients' knowledge towards hypertension. Poor medication adherence was found and different strategies were taken to overcome the barriers towards adherence. Use of herbal and traditional therapies was perceived as alternative method in controlling blood pressure instead of taking antihypertensive medication. The participants were found to have poor knowledge on side effect and mechanism of action of hypertensive medication.

    Conclusions: The misconception about the side effect of antihypertensive medication has led to poor adherence among the participants. Lack of knowledge on targeted blood pressure level has led to poor blood pressure monitoring among the participants. Health awareness program and counselling from health care professional should be advocated among the hypertensive patients in addressing the above gaps.

    Matched MeSH terms: Blood Pressure; Blood Pressure Determination
  18. Fulltext A randomised controlled trial of a facebook-based physical activity intervention for government employees with metabolic syndrome
    Chee, H.P., Hazizi, A.S., Barakatun Nisak, M.Y., Mohd Nasir, M.T.
    Malays J Nutr, 2014;20(2):165-181.
    MyJurnal
    Introduction: This study aimed to ascertain the effects of a Facebook-based physical activity intervention on improvements in step counts and metabolic syndrome. Methods: Government employees with metabolic syndrome were randomly assigned by cluster to the Facebook group (n = 44) or the control group (n = 103). All participants were asked to complete self-administered questionnaires at baseline, after the first and second phases. Data from anthropometric (weight, body mass index, fat mass, body fat percentage, waist circumference, hip circumference and waist-to-hip ratio), biochemical (total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides and fasting glucose) and clinical examinations (systolic blood pressure and diastolic blood pressure) were collected. The number of steps per day was determined by a Lifecorder e- STEP accelerometer. Results: A significant difference in the number of steps per day between the baseline and the first phase (p
    Matched MeSH terms: Blood Pressure
  19. Fulltext A rare case of Riamet induced prolonged corrected QT interval
    Neesha Sundramoorthy, Khaiteri R., Jer Ming Low, Chan Soon Thim Darren
    Malaysian Journal of Medicine and Health Sciences, 2019;15(106):70-70.
    MyJurnal
    Introduction: Artemether and lumefantrine was registered as Riamet in Switzerland in 1999 and is commonly used in Keningau Hospital for managing uncomplicated malaria. Riamet works at the food vacoule of the malarial parasite, where they interfere with the conversion of heme into haemozoin. Case description: We report a case of Riamet induced prolonged corrected QT interval (QTc) in a 37 year old gentleman admitted for severe malaria (hypotension) with normal QTc of 420msc on presentation. Upon starting Riamet, he developed bradycardia and ECG showed sinus bradycardia with prolonged QTc of 551msec and no arrythmias. Echocardiography showed no structural heart abnormalities. All electrolytes were within normal range. He was monitored in cardiac care unit with decision to complete 6 doses of Riamet. Patient was started on Dopamine infusion which maintained his blood pressure and heart rate within normal range. 5 days post Riamet completion, his heart rate improved and dopamine infusion was tapered off and QTc normalized to 407msc. Discussion: The most common mechanism of drugs causing QT inter-val prolongation is by blocking the human ether-à-go-go related gene (hERG) potassium channel. Blockage of the hEGR channel lengthens ventricular re-polarization and duration of ventricular action potential which is reflected in ECG as prolonged QT interval. In the in-vitro whole cell patch clamp study, lumefantrine and its metabolite desbu-tyl-lumefantrine showed a concentration-dependent inhibition of the hERG current. The period of QTc prolongation was 3.5 to 4 days after the last dose of the standard 6 dose regimen. Conclusion: Riamet induced prolonged QTc is a very rare complication. A baseline electrocardiography is therefore imminent for every patient prior to initiation of this medication to avoid cardiac arrythmias.
    Matched MeSH terms: Blood Pressure
  20. Fulltext A report on an unusual presentation of autonomic dysreflexia
    Suhaida SS, Engkasan JP
    Med J Malaysia, 2012 Dec;67(6):616-7.
    PMID: 23770957 MyJurnal
    A 48-year-old male with complete tetraplegia C6 presented with sweating and flushing of the right half of the face and neck that recurred when lying in supine and left lateral positions. The symptoms subsided immediately upon sitting upright or lying in a right lateral position. The symptoms were associated with occasional mild head discomfort rather than headache and were accompanied by marked elevation of blood pressure, which was 190-200/120-130 mmHg compared to his previous baseline blood pressure of 80-90/50-70 mmHg, and he had a heart rate of 60-70 beats per minute. We believe that post-traumatic syringomyelia, found upon further investigation, was the cause of the Autonomic dysreflexia (AD) in this patient. He was advised to avoid the positions causing the symptoms and the progression of symptoms was monitored regularly. AD might not have been diagnosed in this patient because of the atypical and unusual presentations. Therefore, knowledge and a heightened level of awareness of this possible complication are important when treating individuals with spinal cord injury (SCI).
    Matched MeSH terms: Blood Pressure
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