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How little luteal tissue of rats is needed to maintain pregnancy till term--an experimental verification

Chatterjee A, Chatterjee R

Acta Anat (Basel), 1992;144(4):329-31.
PMID: 1414199

Surgical reduction of luteal tissue to about 20% of its total mass on day 5 pc was found to maintain gestation till term. A high degree of fetal loss was, however, evident. An identical surgical manipulation at the end of maximal luteal maturity, that is, on day 16 pc, resulted in normal maintenance of gestation. Fetal growth and their survival rate were found to be comparable to controls. An exclusive surgical extirpation of corpora lutea, on the other hand, either on day 16, 17, 18 or 19 was found to cause 100% fetal loss by day 23. However, progesterone replacement therapy concurrently with surgical luteal ablation till day 20, or surgical extirpation of the entire luteal mass when shifted on day 20, led the pregnancy to term. Present experimental findings, therefore, suggest that only about 20% of the functionally matured luteal mass until day 20 is essentially enough to maintain an ideal pregnancy status till term.

Matched MeSH terms: Fetal Death/etiology; Fetal Death/prevention & control
Sudden infant death syndrome: Knowledge and practise in parents of preterm infants

Rohana J, Ishak S, Wan Nurulhuda WMZ

Pediatr Int, 2018 Aug;60(8):710-713.
PMID: 29804322 DOI: 10.1111/ped.13605

BACKGROUND: Preterm infants are at higher risk of sudden infant death syndrome (SIDS) compared with term born infants and the risk is inversely proportional to the gestational age and birthweight. Parents of these infants should have adequate knowledge and practise the recommended SIDS risk reduction measures.
METHODS: A survey was conducted between December 2016 and August 2017 at Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur. Parents of preterm infants ≤36 weeks' gestation were invited to answer a self-administered questionnaire to assess their knowledge and practise regarding SIDS risk reduction.
RESULTS: Forty-nine (61.33%) of the 80 parents had heard of SIDS prior to the interview, with social media being the commonest source of information (67.3%). Only 35 (43.7%) correctly answered at least five of nine questions on knowledge of SIDS risk reduction ("good knowledge"). When compared with the group of parents who answered less than five questions correctly ("poor knowledge"), there was no significant difference in the demographic and infant characteristics between the groups. The majority (68.8%) of parents practised bed sharing with their infants, and this was significantly more common in the group of parents with poor knowledge (P = 0.01). Household smoking was also significantly more common in the group of parents with poor knowledge (P = 0.048).
CONCLUSION: Knowledge on SIDS risk reduction measures was generally poor among parents of preterm infants in this study. Cigarette smoking, bed sharing and non-supine sleep positions, which are associated with increased risk of SIDS, were common practise among the present subjects.

Matched MeSH terms: Sudden Infant Death/etiology; Sudden Infant Death/prevention & control*
Fulltext Overlap of Bickerstaff brainstem encephalitis/Guillain-Barré syndrome simulating brain death

Tan CY, Ahmad SB, Goh KJ, Latif LA, Shahrizaila N

Neurol India, 2018 9 21;66(5):1475-1480.
PMID: 30233023 DOI: 10.4103/0028-3886.241342
Matched MeSH terms: Brain Death/diagnosis*; Brain Death/physiopathology
Fulltext Some current challenges facing the athlete and their doctor

Brun SP

Aust J Gen Pract, 2020 2 3;49(1-2):23-31.
PMID: 32008269 DOI: 10.31128/AJGP-09-19-5081

BACKGROUND: Primary care physicians are often responsible for the care of people involved in sporting and exercise activities at various competitive levels. Issues confronting the athlete and their primary care physician are the potentially serious risks, responsibilities and challenges facing those involved with sport and physical activity.
OBJECTIVE: The aim of this article is to address three of the most important challenges currently facing the athlete and primary care physician caring for athletes. The challenges are to recognise the potential risks to the athlete of sustaining a sudden cardiac arrest, sports-related concussion or doping violation in sport, as each of these have serious implications for life, wellbeing, performance and/or reputation. Education and risk mitigation are also essential components of care that will be addressed.
DISCUSSION: The primary care physician caring for athletes has a pivotal role in ensuring appropriate screening, education and ongoing surveillance to minimise the potentially serious risks facing those involved with physical activity.

Matched MeSH terms: Death, Sudden, Cardiac/epidemiology; Death, Sudden, Cardiac/prevention & control
Fulltext Asian Sudden Cardiac Death in Heart Failure (ASIAN-HF) registry

Lam CS, Anand I, Zhang S, Shimizu W, Narasimhan C, Park SW, et al.

Eur J Heart Fail, 2013 Aug;15(8):928-36.
PMID: 23568645 DOI: 10.1093/eurjhf/hft045

Our aim is to determine mortality and morbidity in Asian patients under clinical management for heart failure (HF). Specifically, we will define the incidence of, and risk factors for, sudden cardiac death, as well as the socio-cultural factors influencing therapeutic choices in these patients. Methods This is a prospective observational multinational Asian registry of 5000 patients with symptomatic HF (stage C) and LV systolic dysfunction (EF ≤ 40%) involving 44 centres across 11 Asian regions (China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, Philippines, Singapore, Taiwan and Thailand). Data collection includes demographic variables, clinical symptoms, functional status, date of HF diagnosis and prior cardiovascular investigations, clinical risk factors, lifestyle factors, socio-economic status, and survey of cultural beliefs, health practices, and attitudes towards device therapy. Centre-level characteristics (case load, referral pattern, specialization, and infrastructure) are also obtained. Patients uniformly undergo standard 12-lead ECG and transthoracic echocardiography at baseline, and are followed over 3 years for outcomes of death or hospitalization. The mode of death and cause of hospitalization are adjudicated by a central event adjudication committee using pre-specified criteria. Perspective By providing prospective data regarding the demographics, risk factors, and outcomes of Asian patients under treatment for HF, the ASIAN-HF registry is expected to advance fundamental understanding of the burden and predictors of death and hospitalization among these patients. The knowledge gained will be important for guiding resource allocation and planning preventive strategies to address the unmet and growing clinical needs of patients with cardiovascular disease in Asia. Trial registration NCT01633398.

Matched MeSH terms: Death, Sudden, Cardiac/etiology; Death, Sudden, Cardiac/epidemiology*
Sudden maternal deaths in Malaysia: a case report

Jegasothy R

J Obstet Gynaecol Res, 2002 Aug;28(4):186-93.
PMID: 12452259

We report on a retrospective study of maternal deaths in Malaysia that occurred within 24 hours of delivery, abortion or operative termination of the pregnancy (defined as sudden deaths) in the years 1995-1996. There were 131 sudden maternal deaths (20.6% of all maternal deaths); postpartum hemorrhage, obstetric embolisms, trauma and hypertensive disorders of pregnancy were the main causes. There was a disproportionately increased risk of sudden maternal deaths in the Chinese and the 'other bumiputra' racial groups. The proportion of mothers who had no obstetric risk factors in the pregnancy that led to death was 16.8%. Fourteen mothers died in transit Twenty mothers died after a cesarean section. The findings of this review emphasize the fact that caregivers in obstetrics need to be forever vigilant. All maternity staff need to be well trained in emergency care and there needs to be quick referral to centers that can provide expertise in handling these emergencies.

Matched MeSH terms: Cause of Death; Death, Sudden/ethnology; Death, Sudden/etiology; Death, Sudden/epidemiology*
The cathepsin B inhibitor z-FA-CMK induces cell death in leukemic T cells via oxidative stress

Liow KY, Chow SC

Naunyn Schmiedebergs Arch Pharmacol, 2018 Jan;391(1):71-82.
PMID: 29085973 DOI: 10.1007/s00210-017-1436-6

The cathepsin B inhibitor benzyloxycarbonyl-phenylalanine-alanine-chloromethyl ketone (z-FA-CMK) was recently found to induce apoptosis at low concentrations in Jurkat T cells, while at higher concentrations, the cells die of necrosis. In the present study, we showed that z-FA-CMK readily depletes intracellular glutathione (GSH) with a concomitant increase in reactive oxygen species (ROS) generation. The toxicity of z-FA-CMK in Jurkat T cells was completely abrogated by N-acetylcysteine (NAC), suggesting that the toxicity mediated by z-FA-CMK is due to oxidative stress. We found that L-buthionine sulfoximine (BSO) which depletes intracellular GSH through the inhibition of GSH biosynthesis in Jurkat T cells did not promote ROS increase or induce cell death. However, NAC was still able to block z-FA-CMK toxicity in Jurkat T cells in the presence of BSO, indicating that the protective effect of NAC does not involve GSH biosynthesis. This is further corroborated by the protective effect of the non-metabolically active D-cysteine on z-FA-CMK toxicity. Furthermore, in BSO-treated cells, z-FA-CMK-induced ROS increased which remains unchanged, suggesting that the depletion of GSH and increase in ROS generation mediated by z-FA-CMK may be two separate events. Collectively, our results demonstrated that z-FA-CMK toxicity is mediated by oxidative stress through the increase in ROS generation.

Matched MeSH terms: Cell Death/drug effects; Cell Death/physiology
Fulltext Functional validation of putative toxin-antitoxin genes from the Gram-positive pathogen Streptococcus pneumoniae: phd-doc is the fourth bona-fide operon

Chan WT, Yeo CC, Sadowy E, Espinosa M

Front Microbiol, 2014;5:677.
PMID: 25538695 DOI: 10.3389/fmicb.2014.00677

Bacterial toxin-antitoxin (TAs) loci usually consist of two genes organized as an operon, where their products are bound together and inert under normal conditions. However, under stressful circumstances the antitoxin, which is more labile, will be degraded more rapidly, thereby unleashing its cognate toxin to act on the cell. This, in turn, causes cell stasis or cell death, depending on the type of TAs and/or time of toxin exposure. Previously based on in silico analyses, we proposed that Streptococcus pneumoniae, a pathogenic Gram-positive bacterium, may harbor between 4 and 10 putative TA loci depending on the strains. Here we have chosen the pneumococcal strain Hungary(19A)-6 which contains all possible 10 TA loci. In addition to the three well-characterized operons, namely relBE2, yefM-yoeB, and pezAT, we show here the functionality of a fourth operon that encodes the pneumococcal equivalent of the phd-doc TA. Transcriptional fusions with gene encoding Green Fluorescent Protein showed that the promoter was slightly repressed by the Phd antitoxin, and exhibited almost background values when both Phd-Doc were expressed together. These findings demonstrate that phd-doc shows the negative self-regulatory features typical for an authentic TA. Further, we also show that the previously proposed TAs XreA-Ant and Bro-XreB, although they exhibit a genetic organization resembling those of typical TAs, did not appear to confer a functional behavior corresponding to bona fide TAs. In addition, we have also discovered new interesting bioinformatics results for the known pneumococcal TAs RelBE2 and PezAT. A global analysis of the four identified toxins-antitoxins in the pneumococcal genomes (PezAT, RelBE2, YefM-YoeB, and Phd-Doc) showed that RelBE2 and Phd-Doc are the most conserved ones. Further, there was good correlation among TA types, clonal complexes and sequence types in the 48 pneumococcal strains analyzed.

Matched MeSH terms: Cell Death
Morbidity and mortality patterns in Malaysian children

Kasim MS, Paramjothy M

J Singapore Paediatr Soc, 1987;29 Suppl 1:24-31.
PMID: 3657092
Matched MeSH terms: Cause of Death
Fulltext Chlamydia and Its Many Ways of Escaping the Host Immune System

Wong WF, Chambers JP, Gupta R, Arulanandam BP

J Pathog, 2019;2019:8604958.
PMID: 31467721 DOI: 10.1155/2019/8604958

The increasing number of new cases of Chlamydia infection worldwide may be attributed to the pathogen's ability to evade various host immune responses. Summarized here are means of evasion utilized by Chlamydia enabling survival in a hostile host environment. The pathogen's persistence involves a myriad of molecular interactions manifested in a variety of ways, e.g., formation of membranous intracytoplasmic inclusions and cytokine-induced amino acid synthesis, paralysis of phagocytic neutrophils, evasion of phagocytosis, inhibition of host cell apoptosis, suppression of antigen presentation, and induced expression of a check point inhibitor of programmed host cell death. Future studies could focus on the targeting of these molecules associated with immune evasion, thus limiting the spread and tissue damage caused by this pathogen.

Matched MeSH terms: Cell Death
Fulltext A large left ventricular tumour presenting with arrhythmias in a 2-month-old infant

Wan Adlina Wan Yusuf, Amelia Alias, Wan Hanifah Wan Hussin1, Mohd Nasir Abdul Kadir, Abdul Rahim Wong

Malaysian Journal of Paediatrics and Child Health, 2018;24(2):1-5.
MyJurnal

Primary cardiac tumours (PCT) are rare in the paediatric population. They can present in a variety of ways – from being asymptomatic, obstructive with heart failure, strokes, arrhythmias or sudden death. We present a 2-month-old child who was admitted because of heart failure from varying types of arrhythmias and was found on echocardiography to have a large left ventricular tumour. A high clinical suspicion in any infant or child who presents with an unexplained heart murmur, arrhythmias or congestive heart failure should prompt relevant investigations ruling out this entity.

Matched MeSH terms: Death, Sudden
The scope for primary prevention of coronary heart disease in Malaysia

Quek DKL

Family Practitioner, 1988;11(1):90-91.

Cardiovascular disease has been the premier cause of hospital-registered deaths in Malaysia for the past 8 years. Among these reported deaths, 31% were caused by coronary heart disease in 1982. A healthy lifestyle to control the coronary risk factors would help to reduce the incidence of coronary heart disease in future.

Matched MeSH terms: Death
Fulltext Utilization of implantable cardioverter-defibrillators for the prevention of sudden cardiac death in emerging countries: Improve SCA clinical trial

Zhang S, Ching CK, Huang D, Liu YB, Rodriguez-Guerrero DA, Hussin A, et al.

Heart Rhythm, 2020 03;17(3):468-475.
PMID: 31561030 DOI: 10.1016/j.hrthm.2019.09.023

BACKGROUND: Implantable cardioverter-defibrillators (ICDs) are underutilized in Asia, Latin America, Eastern Europe, the Middle East, and Africa. The Improve SCA Study is the largest prospective study to evaluate the benefit of ICD therapy in underrepresented geographies. This analysis reports the primary objective of the study.
OBJECTIVES: The objectives of this study was to determine whether patients with primary prevention (PP) indications with specific risk factors (1.5PP: syncope, nonsustained ventricular tachycardia, premature ventricular contractions >10/h, and low ventricular ejection fraction <25%) are at a similar risk of life-threatening arrhythmias as patients with secondary prevention (SP) indications and to evaluate all-cause mortality rates in 1.5PP patients with and without devices.
METHODS: A total of 3889 patients were included in the analysis to evaluate ventricular tachycardia or fibrillation therapy and mortality rates. Patients were stratified as SP (n = 1193) and patients with PP indications. The PP cohort was divided into 1.5PP patients (n = 1913) and those without any 1.5PP criteria (n = 783). The decision to undergo ICD implantation was left to the patient and/or physician. The Cox proportional hazards model was used to compute hazard ratios.
RESULTS: Patients had predominantly nonischemic cardiomyopathy. The rate of ventricular tachycardia or fibrillation in 1.5PP patients was not equivalent (within 30%) to that in patients with SP indications (hazard ratio 0.47; 95% confidence interval 0.38-0.57) but was higher than that in PP patients without any 1.5PP criteria (hazard ratio 0.67; 95% confidence interval 0.46-0.97) (P = .03). There was a 49% relative risk reduction in all-cause mortality in ICD implanted 1.5PP patients. In addition, the number needed to treat to save 1 life over 3 years was 10.0 in the 1.5PP cohort vs 40.0 in PP patients without any 1.5PP criteria.
CONCLUSION: These data corroborate the mortality benefit of ICD therapy and support extension to a selected PP population from underrepresented geographies.

Matched MeSH terms: Death, Sudden, Cardiac/etiology; Death, Sudden, Cardiac/epidemiology; Death, Sudden, Cardiac/prevention & control*
Fulltext Dataset of driving behaviours in Selangor, Malaysia

You HW, Abdul Rahman A, Hendri Dwisatrya LH

Data Brief, 2020 Aug;31:105783.
PMID: 32642504 DOI: 10.1016/j.dib.2020.105783

Road traffic accidents have been recognised as a leading cause of death, and one of the prominent public health problems. The human factor, which is the driving behaviour in particular, is said to be the main cause. In line with this, the objective of this research is to present a data article on the response of driving behaviours among drivers. Driving behaviours have been classified into five dimensions, which are speeding, improper overtaking, mobile phone use while driving, tail-gating and disobeying traffic lights. A quantitative study was conducted with a sample size of 160 drivers consisting of residents in a suburban of Selangor, Malaysia. A stratified random sampling method was adopted to identify the respondents. Data analysis was presented in the form of descriptive statistics and tables. The findings show that the majority of respondents agreed that they have driving behaviours that involve improper overtaking, tail-gating and disobeying traffic lights.

Matched MeSH terms: Cause of Death
Fulltext Apoptosis: Dual Role in Aetiology and Cure

Wynn, Aye Aye, Myint, Ohnmar, Mya, Nang Khin

Borneo Journal of Medical Sciences, 2019;13(3):5-10.
MyJurnal

Apoptosis is a programmed cell death which occurs following a variety of stimuli. Physiologically the process is important for morphogenesis of organs and homeostasis of different types of cells. Apoptotic cell death is responsible for a variety of pathologic states such as elimination of cell death in mutated cells, infected cells, tumour cells and transplant rejection well as the pathological atrophy. In this review, there is discussion about the control of apoptosis, detection methods of apoptosis, its association with infectious and non-communicable diseases. Intracellular microorganisms survive through inhibition of host cell apoptosis as well as they destroy the parenchymal cells causing impaired functions. It plays important role in tumourigenesis. There are possible therapeutic roles of drugs that modify apoptosis in human diseases.

Matched MeSH terms: Cell Death
Perspectives and advancements in the design of nanomaterials for targeted cancer theranostics

Tan YY, Yap PK, Xin Lim GL, Mehta M, Chan Y, Ng SW, et al.

Chem Biol Interact, 2020 Sep 25;329:109221.
PMID: 32768398 DOI: 10.1016/j.cbi.2020.109221

Cancer continues to be one of the most challenging diseases to be treated and is one of the leading causes of deaths around the globe. Cancers account for 13% of all deaths each year, with cancer-related mortality expected to rise to 13.1 million by the year 2030. Although, we now have a large library of chemotherapeutic agents, the problem of non-selectivity remains the biggest drawback, as these substances are toxic not only to cancerous cells, but also to other healthy cells in the body. The limitations with chemotherapy and radiation have led to the discovery and development of novel strategies for safe and effective treatment strategies to manage the menace of cancer. Researchers have long justified and have shed light on the emergence of nanotechnology as a potential area for cancer therapy and diagnostics, whereby, nanomaterials are used primarily as nanocarriers or as delivery agents for anticancer drugs due to their tumor targeting properties. Furthermore, nanocarriers loaded with chemotherapeutic agents also overcome biological barriers such as renal and hepatic clearances, thus improving therapeutic efficacy with lowered morbidity. Theranostics, which is the combination of rationally designed nanomaterials with cancer-targeting moieties, along with protective polymers and imaging agents has become one of the core keywords in cancer research. In this review, we have highlighted the potential of various nanomaterials for their application in cancer therapy and imaging, including their current state and clinical prospects. Theranostics has successfully paved a path to a new era of drug design and development, in which nanomaterials and imaging contribute to a large variety of cancer therapies and provide a promising future in the effective management of various cancers. However, in order to meet the therapeutic needs, theranostic nanomaterials must be designed in such a way, that take into account the pharmacokinetic and pharmacodynamics properties of the drug for the development of effective carcinogenic therapy.

Matched MeSH terms: Cause of Death
Role of radiotherapy in early breast cancer: an overview

Joshi SC, Khan FA, Pant I, Shukla A

Int J Health Sci (Qassim), 2007 Jul;1(2):259-64.
PMID: 21475437

Radiotherapy has an established role in reducing the local relapses in breast cancer patients. The objective of this review was to investigate whether radiotherapy or its omission after breast surgery has measurable consequences on local tumor recurrence and patient survival. The late excess of cardiac deaths has also been published in various reports but important advances in the delivery of radiotherapy have overcome this problem to the extent that, excess cardiac deaths do not appear to be occurring in more recent trials. In this article some recent data, suggesting that radiotherapy following mastectomy and/or breast conserving surgery has a beneficial effect on survival is reviewed. Omission of radiotherapy is associated with a large increase in risk of ipsilateral breast tumor recurrence and with a small increase in the risk of patient's mortality.

Matched MeSH terms: Death, Sudden, Cardiac
Fulltext Mastering tasks of adolescence: the key to optimum end -of- life care of an adolescent dying of cancer.

Suriati Mohamed Saini, Susan, Mooi KoonTan.

ASEAN Journal of Psychiatry, 2011;12(1):0-0.
MyJurnal

Objective: This case report highlights the optimum end-of-life care of an adolescent dying of cancer. Method: We report our experience, as part of a multidisciplinary team in managing the cancers of a female student who died an untimely death at the age of 15. Results: Our role of motivating her for chemotherapy of her initial treatable carcinoma, became that of palliative care upon discovery of a second malignancy. We helped the patient “live life to the fullest” during her last days, she helped us realize that helping her master the tasks of adolescence was optimum “end-of-life care” as well. Conclusion: to help an ill adolescent die with dignity is to help her live whatever time she has left of her life. Allowing her to participate in decisions regarding her treatment and in other bio-psycho-social needs of that stage of life is crucial in helping her prepare for the end of life.

Matched MeSH terms: Death
Fulltext Acute appendicitis in pregnancy: a diagnostic and management challenge

Zainur Rashid, Z., Sulaiha, S.A., Azmi, M.N.

International Medical Journal Malaysia, 2014;13(1):77-80.
MyJurnal

Acute appendicitis is the most common extra-uterine surgical emergency encountered during pregnancy, but an accurate diagnosis is still an enigma. Anatomical shifting of the appendix by the enlarging uterus makes the clinical and sonographic diagnosis difficult. Prompt diagnosis and treatment are essential to prevent perforation, which increases the risk of fetal and maternal death. Surgical intervention, either by an open laparotomy or laparoscopy is the most appropriate treatment for appendicitis. This article reviews the epidemiology, clinical diagnosis, investigation, complications and treatment of acute appendicitis in pregnancy.

Matched MeSH terms: Maternal Death
Fulltext Developing the cost for uncomplicated acute ST Elevated Myocardial Infarction (STEMI primary percutaneous coronary intervention) using step down and activity based costing at UKMMC

Aniza, I., Syafrawati, Saperi, S., Zafar, M., Amrizal, M.N., Ika Fazura, M.N.

Malaysian Journal of Community Health, 2011;17(1):26-31.
MyJurnal

Background: Cardiovascular disease is the number one cause of death globally and is projected to remain the leading cause of death. If the trend is allowed to continue, by 2015 an estimated 20 million people will die from cardiovascular disease (mainly because of myocardial infarction and strokes). The number of cardiovascular disease cases in Malaysia has increased to 14% in five years from 96,000 cases in 1995 to 110,000 cases in 2000.

Methods: The cost to treat patients admitted to Universiti Kebangsaan Malaysia Medical Center (UKMMC) Malaysia, diagnosed with Acute Uncomplicated ST Elevated Myocardial Infarction (STEMI) was calculated by using two different methodologies, namely step down costing methodology and activity based costing using clinical pathway.

Results: Cost for each stay per day at the cardiology ward using the step down methodology is RM596.42. The treatment cost is estimated from RM1, 789.26 to RM 4,771.36. The average cost per episode for STEMI care with the average length of stay for 5.6 days is RM3, 340(SD ±596.42. The cost of coronary PCI procedure in step costing is RM 13,950.00. Hence, the total cost incurs for STEMI with PCI is RM 17,290.00(SD ±596.42) by using step down method. (an average cost per episode is RM3,340, plus the cost of coronary procedure of RM 13,950.00 . However by using the ABC the cost of STEMI (PCI) with an average length of stay for 5.6 days is RM 20,431.39. The study showed the ABC method was higher by 15.3% than the step down costing.

Conclusion: The cost in managing STEMI (PCI) with the average length of stay of 5.6 days was calculated by using two different methodologies, namely step down costing methodology and activity based costing. Cost of treatment calculated by using activity based costing are higher because all resources used are incorporated in detail. The ABC method was higher by 15.3% than the step down costing. The difference is within 80-20 rules and the biggest percentage of cost in both methodsis procedure or PCI cost.

Matched MeSH terms: Cause of Death

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