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Fulltext Design, synthesis and therapeutic potential of 3-(2-(1H-benzo[d]imidazol-2-ylthio)acetamido)-N-(substituted phenyl)benzamide analogues

Tahlan S, Ramasamy K, Lim SM, Shah SAA, Mani V, Narasimhan B

Chem Cent J, 2018 Dec 19;12(1):139.
PMID: 30569392 DOI: 10.1186/s13065-018-0513-3

BACKGROUND: The emergence of bacterial resistance is a major public health problem. It is essential to develop and synthesize new therapeutic agents with better activity. The mode of actions of certain newly developed antimicrobial agents, however, exhibited very limited effect in treating life threatening systemic infections. Therefore, the advancement of multi-potent and efficient antimicrobial agents is crucial to overcome the increased multi-drug resistance of bacteria and fungi. Cancer, which remains as one of the primary causes of deaths and is commonly treated by chemotherapeutic agents, is also in need of novel and efficacious agents to treat resistant cases. As such, a sequence of novel substituted benzamides was designed, synthesized and evaluated for their antimicrobial and anticancer activities.
METHODOLOGY: All synthesized compounds were characterized by IR, NMR, Mass and elemental analysis followed by in vitro antimicrobial studies against Gram-positive (Staphylococcus aureus), Gram-negative (Salmonella typhi and Klebsiella pneumoniae) bacterial and fungal (Candida albicans and Aspergillus niger) strains by the tube dilution method. The in vitro anticancer evaluation was carried out against the human colorectal carcinoma cell line (HCT116), using the Sulforhodamine B assay.
RESULTS, DISCUSSION AND CONCLUSION: Compound W6 (MICsa, st, kp = 5.19 µM) emerged as a significant antibacterial agent against all tested bacterial strains i.e. Gram-positive (S. aureus), Gram-negative (S. typhi, K. pneumoniae) while compound W1 (MICca, an = 5.08 µM) was most potent against fungal strains (A. niger and C. albicans) and comparable to fluconazole (MIC = 8.16 µM). The anticancer screening demonstrated that compound W17 (IC50 = 4.12 µM) was most potent amongst the synthesized compounds and also more potent than the standard drug 5-FU (IC50 = 7.69 µM).

Matched MeSH terms: Cause of Death
Health Outcomes of Deprescribing Interventions Among Older Residents in Nursing Homes: A Systematic Review and Meta-analysis

Kua CH, Mak VSL, Huey Lee SW

J Am Med Dir Assoc, 2019 03;20(3):362-372.e11.
PMID: 30581126 DOI: 10.1016/j.jamda.2018.10.026

OBJECTIVES: Deprescribing is effective in addressing concerns relating to polypharmacy in residents of nursing homes. However, the clinical outcomes of deprescribing interventions among residents in nursing homes are not well understood. We evaluated the impact of deprescribing interventions by health care professionals on clinical outcomes among the older residents in nursing homes.
DESIGN: Systematic review and meta-analysis of randomized controlled trials. CINAHL, International Pharmaceutical Abstracts, MEDLINE, EMBASE, and Cochrane Library were searched from inception until September 2017; manual searches of reference lists of systematic reviews identified in the electronic search; and online trial registries for unpublished, ongoing, or planned trials. (PROSPERO CRD42016050028).
SETTING AND PARTICIPANTS: Randomized controlled trials in a nursing home setting that included participants of at least 60 years of age.
MEASURES: Falls, all-cause mortality, hospitalization, and potentially inappropriate medication were assessed in the meta-analysis.
RESULTS: A total of 41 randomized clinical studies (18,408 residents) that examined deprescribing (defined as either medication discontinuation, substitution, or reduction) in nursing were identified. Deprescribing interventions significantly reduced the number of residents with potentially inappropriate medications by 59% (odds ratio [OR] 0.41, 95% confidence interval [CI] 0.19-0.89). In subgroup analysis, medication review-directed deprescribing interventions reduced all-cause mortality by 26% (OR 0.74, 95% CI 0.65-0.84), as well as the number of fallers by 24% (OR 0.76, 95% CI 0.62-0.93).
CONCLUSIONS: Compared to other deprescribing interventions, medication review-directed deprescribing had significant benefits on older residents in nursing homes. Further research is required to elicit other clinical benefits of medication review-directed deprescribing practice.

Matched MeSH terms: Cause of Death
Fulltext Effects of Non-statin Lipid-Modifying Agents on Cardiovascular Morbidity and Mortality Among Statin-Treated Patients: A Systematic Review and Network Meta-Analysis

Chaiyasothi T, Nathisuwan S, Dilokthornsakul P, Vathesatogkit P, Thakkinstian A, Reid C, et al.

Front Pharmacol, 2019;10:547.
PMID: 31191304 DOI: 10.3389/fphar.2019.00547

Background: Currently, there is a lack of information on the comparative efficacy and safety of non-statin lipid-lowering agents (NST) in cardiovascular (CV) disease risk reduction when added to background statin therapy (ST). This study determine the relative treatment effects of NST on fatal and non-fatal CV events among statin-treated patients. Methods: A network meta-analysis based on a systematic review of randomized controlled trials (RCTs) comparing non-statin lipid-modifying agents among statin-treated patients was performed. PubMed, EMBASE, CENTRAL, and Clinicaltrial.gov were searched up to April 10, 2018. The primary outcomes were CV and all-cause mortalities. Secondary CV outcomes were coronary heart disease (CHD) death, non-fatal myocardial infarction (MI), any stroke, and coronary revascularization. Risks of discontinuations were secondary safety outcomes. Results: Sixty-seven RCTs including 259,429 participants with eight interventions were analyzed. No intervention had significant effects on the primary outcomes (CV mortality and all-cause mortality). For secondary endpoints, proprotein convertase subtilisin/kexin type 9 inhibitor (PCSK) plus statin (PCSK/ST) significantly reduced the risk of non-fatal MI (RR 0.82, 95% CI 0.72-0.93, p = 0.003), stroke (RR 0.74, 95% CI 0.65-0.85, p < 0.001), coronary revascularization (RR 0.84, 95% CI 0.75-0.94, p = 0.003) compared to ST. Combinations of ST and all NST except PCSK and ezetimibe showed higher rate of discontinuation due to adverse events compared to ST. Conclusions: None of NST significantly reduced CV or all-cause death when added to ST. PCSKs and to a lesser extent, ezetimibe may help reduce cardiovascular events with acceptable tolerability profile among broad range of patients.

Matched MeSH terms: Cause of Death
Fulltext Childhood-Onset Systemic Lupus Erythematosus: Southeast Asian Perspectives

Tang SP, Lim SC, Arkachaisri T

J Clin Med, 2021 Feb 03;10(4).
PMID: 33546120 DOI: 10.3390/jcm10040559

Childhood onset systemic lupus erythematosus is a rare disease that is more common amongst Southeast Asian children compared to the West. It is typified by a peripubertal onset and a female preponderance, which increases with advancing age. Organs commonly involved at diagnosis include haematological, renal, and mucocutaneous. Fever, malar rash, and cutaneous vasculitis are common. Lupus nephritis is typically proliferative especially Class IV and contributes to both disease activity and damage. Antinuclear antibody and anti-dsDNA positivity are both prevalent in this region. Disease activity is higher than Western cohorts at onset but responds to therapy reducing to low disease activity by six months. However, organ damage occurs early and continues to accumulate over the time, a consequence of both active disease (neurological and renal systems) and steroid-related complications especially in the eye (cataract and glaucoma) and musculoskeletal systems (avascular necrosis). Infections remain the leading cause of death and mortality in this region is highly variable contributed by the heterogeneity in social economic status, healthcare access, and availability of paediatric rheumatology expertise in the region.

Matched MeSH terms: Cause of Death
Fulltext Improvement of Blue Ribbon certification by including humanistic value (TFI Buddies)

Siti Munira Yasin, Harizah Mad Hisma, Mazlifah Omar, Nurhuda Ismail, Zahir Izuan Azhar, Zalina Omar, et al.

Jurnal Inovasi Malaysia, 2020;4(1):61-78.
MyJurnal

Cigarette smoke produces more than 4,000 toxic chemicals and 53 of these chemicals can cause cancer. Smoking increases your health risks such as lung cancer, heart attack and stroke. In Malaysia, between 10% and 12% of causes of death are caused by smoking and this results in over 10,000 deaths a year. According to the National Health Morbidity Survey (NHMS) in 2015, the number of smokers aged 15 and above in Malaysia is estimated to be more than 5 million (22.8%). This alarming amount will lead to increased health costs. Smoking can also lead to a reduction in worker productivity and air pollution and the pollution due to cigarette smoke. Therefore, smokers need to be aware of the effects of smoking habits and the importance of maintaining a tobacco-free environment for the health and well-being of their families, friends and the community around them. To address this, Smoke Busters have created an innovation called Blue Ribbon Star Certification with an additional component of humanization into the TFI Buddies existing Blue Ribbon Certification. The main goal of this innovation is to make University of Technology MARA (UiTM) campuses 100% tobacco free. The first project at the Sungai Buloh Campus resulted in a decrease in the percentage of ‘hotspots’, whereby the number of cigarette butts was found to be greatly reduced. In addition, the percentage of staff with good knowledge and attitude on the effects of cigarettes increased. Feedback from users comprising staff and students also showed a very positive response. The direct impact on faculty and campuses include cost savings in terms of medical expenses and increase in staff productivity. The long-term effects include enhancing UiTM’s image nationally and internationally. From a social point of view, this in addition creates a more caring and responsible generation of colleagues and the environment.

Matched MeSH terms: Cause of Death
Fulltext Will they swim or sink? parental perception of water safety among their children

Noor Hamzani Farizan, Rosnah Sutan, Kulanthayan KC Mani

Malaysian Journal of Medicine and Health Sciences, 2020;16(1):254-260.
MyJurnal

Introduction: The magnitude of drowning as one of the leading causes of death among children in Malaysia may have been underestimated. Little is known on the level of awareness on water safety among parents as it might be associated with appropriateness and adequacy of the supervision. This study aims to describe perceptions of water safety among parents of primary school children. Methods: A cross-sectional survey with 719 respondent conduct- ed to obtain information on parents self-reported on their children’s water-involved activity and swimming ability, self-estimated ability to rescue their child and perceptions of the risk of drowning and water safety for their children. Results: The result revealed that about 21.6% of respondents did not perceive drowning as one of the unintentional injury leading causes of death among children. Parents reported that their children had experienced a near- drown- ing incident (16.1%), and only 12.2% of the child had attended a formal swimming lesson. Majority of the parents did not involve in any water safety program (98.7%), can’t swim (61.6%), not been certified in CPR (87.3%) and not confident (87.3%) to perform resuscitation (CPR). Respondents also perceived their children could swim (42.1%), and they felt confident when their child in the water (45.6%). There were statistical differences between parents who reported their child had a near-drowning experience with their perception of children’s swimming ability. Conclu- sion: An exploration of parent’s perception of water safety provided an overview of the need for promoting aware- ness on drowning risk and water safety education in this country.

Matched MeSH terms: Cause of Death
Potential forensic implications of kerokan therapy - a traditional Indonesian therapy associated with neck bruising

Samberkar PN, Samberkar SP, Byard RW

Med Sci Law, 2020 Oct;60(4):315-318.
PMID: 32501165 DOI: 10.1177/0025802420926867

Kerokan is a traditional Indonesian treatment involving abrading the skin over various parts of the body with a blunt object such as a coin or a piece of ginger which may create suspicious injuries. Here, the case of a 30-year-old woman who had undergone kerokan therapy is reported. She was complaining of retro-sternal pain and epigastric discomfort and subsequently became markedly short of breath and died. The observation of injuries predominantly located around the neck initiated a police investigation and forensic autopsy. Scattered abrasions, blisters and bruises were present on the forehead, the bridge of the nose extending to the ala, the upper and anterior aspect of the chin and the sternal notch, with discrete fresh and scabbed abrasions around the neck, over the sternum and on the backs of both hands. There were, however, no facial or conjunctival petechiae and no bruising of the underlying strap muscles, or fractures of the hyoid bone or thyroid cartilage. Histology revealed that myocarditis was the cause of death. Traditional practices may cause unusual bruises, abrasions, blisters and burns that may raise suspicion of inflicted injury from an assault. Knowledge of the manifestations of socio-ethnic practices such as kerokan is important in the evaluation of trauma in specific cultural groups.

Matched MeSH terms: Cause of Death
Fulltext Computational prediction of novel broad-spectrum drug targets against Vibrio cholerae by integrated genomics and proteomics approach

Suresh Kumar, Meera Ramanujam

Malaysian Journal of Medicine and Health Sciences, 2020;16(2):99-104.
MyJurnal

Introduction: Vibrio cholerae is a motile, Gram-negative curved rod belonging to the Vibrionaceae family. It is the causative agent of cholera. The acute diarrheal disease cholera causes about 120 000 casualties annually and has a significant effect on the health of young kids between the ages of 1 and 5. The main cause of death is due to resistance to antibiotics. As a result, new drug targets need to be identified immediately. The study’s goal is to identify Vibrio Cholerae’s putative drug target through an integrated approach to genomics and proteomics. Methods: Through this study, 2241 core protein sequence of Vibrio Cholerae were retrieved from the Panx tool. The sequence decreased to 173 druggable sequences by undergoing different phases of the process such as determining the non-homolo- gous sequence against human proteome by using the BlastP tool, identifying the essential genes by using the DEG database, and determining the sequence of virulent proteins by using Virulent prediction tool. Results: 11 potential drug targets were identified through molecular weight, and sub-cellular localization analysis. Conclusion: Through pan-genome analysis, we can able to find potential drug targets. This study also helps to identify the potential drug targets against Vibrio cholerae and to increase the efforts of drug and vaccine developments.

Matched MeSH terms: Cause of Death
Fulltext Microbiome and colorectal cancer: an overview and local perspective

Rahman Jamal

Malaysian Journal of Medicine and Health Sciences, 2019;15(108):4-4.
MyJurnal

Colorectal cancer (CRC) is an important health problem that is on the rise globally, where it is the fourth most com-mon cause of deaths from cancer. CRC is now the 2nd commonest cancer in men and 3rd commonest in women in Malaysia. Diet, lifestyle, genetics and environmental interaction, together with underlying gut conditions such as inflammatory bowel disease have been reported to contribute to the disease. In addition, the gut microbiome has also been increasingly reported to be associated with CRC development, with dysbiosis of the commensal bacteria ob-served in CRC patients. Bacterial genera such as Bacteroides, Fusobacterium and Prevotella are more commonly de-tected in CRC patients compared to healthy individuals. Nevertheless, not much is known about the gut microbiome among Malaysians with different ethnicities. In Malaysia, the Chinese has the highest incidence of CRC, followed by Malays and Indians. The reason behind this difference may be contributed by the differences in the dietary intake that could modulate the gut microbiome and contribute towards the development of CRC. The current knowledge on this field still much depends on reports from individuals of American, European, Chinese, Brazilian and Japanese descendants in origin. The oncogenic potential of bacteria was suggested to include inflammation and the produc-tion of mutagenic toxin. A significant increase in certain intestinal microbiota including the genuses Enteroccus and Streptococcus spp. was detected in the advanced stage of colorectal adenoma. However, there are discrepancies in the previous studies, where some bacteria genera might be over-reported or underestimated. It is likely that the gut microbiome differs between populations. There is also no available data on the gut microbiome of the healthy individuals, colorectal adenoma (pre-cancerous) and colorectal cancer patients in the Malaysian population. Recent advancements in next generation sequencing allow faster and more accurate determination of microbial consortium in various niches of the human body and environment. In particular, sequencing of the 16S rRNA gene with specific primers have been reported to allow accurate determination of bacterial orders commonly found in the human gut as well as for those which are not expected in the digestive system. Recent developments in gut microbiome DNA ex-traction also contributed to the robustness of gut microbiome determination and analysis. All the above will contrib-ute towards an accurate and rapid cataloging process of the Malaysian gut microbiome and also enable comparison between healthy individuals, colorectal adenoma and CRC patients of the Malaysian population.

Matched MeSH terms: Cause of Death
Idiopathic ileal volvulus with multiple concomitant infections in a starving man

Tan LJ, Othman MS, Hiu J, Wong KT, Lai SK

Malays J Pathol, 2021 Apr;43(1):81-85.
PMID: 33903310

BACKGROUND: Small bowel volvulus is defined as the torsion of the small intestine, potentially leading to bowel obstruction, gangrene and perforation. It is a rare condition, especially in adults.
CASE PRESENTATION: A 30-year-old man was retrieved from the jungle with severe weight loss and abdominal symptoms. He succumbed to death despite 22 days of intensive medical treatment. An autopsy revealed a ruptured gangrenous ileal volvulus with peritonitis and subdiaphragmatic abscess. Further laboratory analysis detected systemic Candida tropicalis and intestinal gramnegative bacterial sepsis, systemic Zika virus viremia, leptospirosis complicating rhabdomyolysis and disseminated intravascular coagulopathy, Type I Herpes Simplex virus infection of the tongue and upper gastrointestinal tract. The cause of death was the ruptured ileal volvulus, complicated with upper gastrointestinal bleeding due to Herpes simplex virus esophagitis in a malnourished patient with resolving leptospirosis and underlying Zika virus co-infection.
CONCLUSION: Rare clinical scenarios of adult-onset intestinal volvulus with concomitant multiple infections precludes clinical diagnosis and early treatment, leading to devastating consequences of clinical outcome. The positive clinical and postmortem correlation is a good learning lesson in many disciplines of medicine and science.

Matched MeSH terms: Cause of Death
Fulltext Carriage of upper respiratory tract pathogens in rural communities of Sarawak, Malaysian Borneo

Morris DE, McNeil H, Hocknell RE, Anderson R, Tuck AC, Tricarico S, et al.

Pneumonia (Nathan), 2021 Apr 25;13(1):6.
PMID: 33894778 DOI: 10.1186/s41479-021-00084-9

INTRODUCTION: Pneumonia is a leading cause of death in Malaysia. Whilst many studies have reported the aetiology of pneumonia in Western countries, the epidemiology of pneumonia in Malaysia remains poorly understood. As carriage is a prerequisite for disease, we sought to improve our understanding of the carriage and antimicrobial resistance (AMR) of respiratory tract pathogens in Malaysia. The rural communities of Sarawak are an understudied part of the Malaysian population and were the focus of this study, allowing us to gain a better understanding of bacterial epidemiology in this population.
METHODS: A population-based survey of bacterial carriage was undertaken in participants of all ages from rural communities in Sarawak, Malaysia. Nasopharyngeal, nasal, mouth and oropharyngeal swabs were taken. Bacteria were isolated from each swab and identified by culture-based methods and antimicrobial susceptibility testing conducted by disk diffusion or E test.
RESULTS: 140 participants were recruited from five rural communities. Klebsiella pneumoniae was most commonly isolated from participants (30.0%), followed by Staphylococcus aureus (20.7%), Streptococcus pneumoniae (10.7%), Haemophilus influenzae (9.3%), Moraxella catarrhalis (6.4%), Pseudomonas aeruginosa (6.4%) and Neisseria meningitidis (5.0%). Of the 21 S. pneumoniae isolated, 33.3 and 14.3% were serotypes included in the 13 valent PCV (PCV13) and 10 valent PCV (PCV10) respectively. 33.8% of all species were resistant to at least one antibiotic, however all bacterial species except S. pneumoniae were susceptible to at least one type of antibiotic.
CONCLUSION: To our knowledge, this is the first bacterial carriage study undertaken in East Malaysia. We provide valuable and timely data regarding the epidemiology and AMR of respiratory pathogens commonly associated with pneumonia. Further surveillance in Malaysia is necessary to monitor changes in the carriage prevalence of upper respiratory tract pathogens and the emergence of AMR, particularly as PCV is added to the National Immunisation Programme (NIP).

Matched MeSH terms: Cause of Death
High sensitivity C-reactive protein (hsCRP): Its relationship with metabolic syndrome and Framingham Risk Score

Zahari Sham SY, Hanif E, Thambiah SC, Samsudin IN, Mohd Noor S, Osman M, et al.

Malays J Pathol, 2021 04;43(1):33-40.
PMID: 33903303

INTRODUCTION: Cardiovascular disease (CVD) remains the leading cause of death in Malaysia. Identification of asymptomatic at-risk individuals is often achieved by means of a risk prediction algorithm. Traditional CVD risk factors and their associated algorithms are, however, limited by residual CVD risk. High sensitivity C-reactive protein (hsCRP) has emerged as a novel CVD risk factor. This study aimed to evaluate hsCRP as an adjunct CVD risk marker among the adult Malaysian population by determining its correlation with the Framingham Risk Score (FRS). Comparison analyses were done according to sociodemographic, clinical and laboratory factors and between subjects with and without Metabolic Syndrome (MetS).
METHOD: This cross-sectional study involved eighty-three (n=83) adults attending a health screening program at Universiti Putra Malaysia (UPM). Demographic data, anthropometric measurements and blood samples for fasting blood glucose (FBG), fasting lipid profile (FSL), glycated haemoglobin (HbA1c) and hsCRP were taken. Respondents were grouped according to FRS and the Joint Interim Statement into 10-year CVD risk categories (low, intermediate and high) and MetS, respectively.
RESULTS: hsCRP was significantly increased in patients with high body mass index (BMI) (p=0.001), at-risk waist circumference (WC) (p=0.001) and MetS (p=0.009). Spearman's correlation coefficient showed a significant positive correlation between hsCRP level and total FRS score (r=0.26, p<0.05) and HDL-C score (r=0.22, p<0.05).
CONCLUSION: The significant difference of hsCRP levels across obesity levels and MetS with its modest correlation with FRS scores supported the adjunctive role of hsCRP in CVD risk prediction, most likely capturing the inflammatory pathological aspect and thus partly accounting for the residual CVD risk.

Matched MeSH terms: Cause of Death
Fulltext The effectiveness of probiotics, prebiotics, and dietary fiber on the lowering of cholesterol level and improvement of full lipid profile

Farah Izzati binti Farush Khan, Yasmin Ooi Beng Houi, Patricia Matanjun, Fredie Robinson

Malaysian Journal of Medicine and Health Sciences, 2019;15(106):31-31.
MyJurnal

Introduction: Coronary heart disease (CHD) has become the number one cause of death worldwide. Past studies have established the efficiency of prebiotics, probiotics, and their combination on lowering blood lipids. However, the mechanism(s) on the reduction of cholesterol involved is not fully understood due to limited in-vivo studies. Therefore, the reported hypocholesterolaemic potential of probiotics and prebiotics supplementations warrants fur-ther research. This study examined the effectiveness of the intervention products on improving lipid profiles, (to-tal cholesterol (TC), HDL-C, LDL-C, TG). Methods: A randomized, single blind intervention involving 8 weeks of treatment followed by 4 weeks of washout period was carried out on 29 volunteers with TC 5.2-6.0 mmol/L who were screened from 517 volunteers. Exclusion criteria included chronic diseases, immune-compromised diseases, consumption of cholesterol-lowering drugs, and pregnancy if female. Informed consent was obtained before com-mencement of the study. Participants were randomly assigned to receive 2g/d Lactobacillus Acidophilus NCFM pro-biotic powder, 10g/d inulin, 10g/d dietary fibre, control intervention of 20mg/d statin, or control intervention of diet counseling. Results: No significant (p>0.05) changes were observed in the fasting blood glucose, physical activities and total nutrient intake of all the groups. Inulin reduced LDL-C by 12.13%. Probiotic reduced TC by 6.98%. Dietary fibre reduced TC by 8.6%, and LDL-C by 16.08%. Conclusion: Although the results showed no significant changes, it may be clinically significant as the intervention products improve the lipid profiles. It was concluded that the im-provement in the lipid profiles may be attributable to the intervention products.

Matched MeSH terms: Cause of Death
Fulltext Determining standardized causes of death of infants, children, and adolescents living with HIV in Asia

Sohn AH, Lumbiganon P, Kurniati N, Lapphra K, Law M, Do VC, et al.

AIDS, 2020 08 01;34(10):1527-1537.
PMID: 32443064 DOI: 10.1097/QAD.0000000000002583

OBJECTIVE: To implement a standardized cause of death reporting and review process to systematically disaggregate causes of HIV-related deaths in a cohort of Asian children and adolescents.
DESIGN: Death-related data were retrospectively and prospectively assessed in a longitudinal regional cohort study.
METHODS: Children under routine HIV care at sites in Cambodia, India, Indonesia, Malaysia, Thailand, and Vietnam between 2008 and 2017 were followed. Causes of death were reported and then independently and centrally reviewed. Predictors were compared using competing risks survival regression analyses.
RESULTS: Among 5918 children, 5523 (93%; 52% male) had ever been on combination antiretroviral therapy. Of 371 (6.3%) deaths, 312 (84%) occurred in those with a history of combination antiretroviral therapy (crude all-cause mortality 9.6 per 1000 person-years; total follow-up time 32 361 person-years). In this group, median age at death was 7.0 (2.9-13) years; median CD4 cell count was 73 (16-325) cells/μl. The most common underlying causes of death were pneumonia due to unspecified pathogens (17%), tuberculosis (16%), sepsis (8.0%), and AIDS (6.7%); 12% of causes were unknown. These clinical diagnoses were further grouped into AIDS-related infections (22%) and noninfections (5.8%), and non-AIDS-related infections (47%) and noninfections (11%); with 12% unknown, 2.2% not reviewed. Higher CD4 cell count and better weight-for-age z-score were protective against death.
CONCLUSION: Our standardized cause of death assessment provides robust data to inform regional resource allocation for pediatric diagnostic evaluations and prioritization of clinical interventions, and highlight the continued importance of opportunistic and nonopportunistic infections as causes of death in our cohort.

Matched MeSH terms: Cause of Death
Association between different methods of assessing blood pressure variability and incident cardiovascular disease, cardiovascular mortality and all-cause mortality: a systematic review

Smith TO, Sillito JA, Goh CH, Abdel-Fattah AR, Einarsson A, Soiza RL, et al.

Age Ageing, 2020 02 27;49(2):184-192.
PMID: 31985773 DOI: 10.1093/ageing/afz178

BACKGROUND: Blood pressure variability (BPV) is a possible risk factor for adverse cardiovascular outcomes and mortality. There is uncertainty as to whether BPV is related to differences in populations studied, measurement methods or both. We systematically reviewed the evidence for different methods to assess blood pressure variability (BPV) and their association with future cardiovascular events, cardiovascular mortality and all-cause mortality.
METHODS: Literature databases were searched to June 2019. Observational studies were eligible if they measured short-term BPV, defined as variability in blood pressure measurements acquired either over a 24-hour period or several days. Data were extracted on method of BPV and reported association (or not) on future cardiovascular events, cardiovascular mortality and all-cause mortality. Methodological quality was assessed using the CASP observational study tool and data narratively synthesised.
RESULTS: Sixty-one studies including 3,333,801 individuals were eligible. BPV has been assessed by various methods including ambulatory and home-based BP monitors assessing 24-hour, "day-by-day" and "week-to-week" variability. There was moderate quality evidence of an association between BPV and cardiovascular events (43 studies analysed) or all-cause mortality (26 studies analysed) irrespective of the measurement method in the short- to longer-term. There was moderate quality evidence reporting inconsistent findings on the potential association between cardiovascular mortality, irrespective of methods of BPV assessment (17 studies analysed).
CONCLUSION: An association between BPV, cardiovascular mortality and cardiovascular events and/or all-cause mortality were reported by the majority of studies irrespective of method of measurement. Direct comparisons between studies and reporting of pooled effect sizes were not possible.

Matched MeSH terms: Cause of Death
Lipid Metabolism Genes in Stroke Pathogenesis: The Atherosclerosis

Chow YL, Teh LK, Chyi LH, Lim LF, Yee CC, Wei LK

Curr Pharm Des, 2020;26(34):4261-4271.
PMID: 32534558 DOI: 10.2174/1381612826666200614180958

Stroke is the second leading cause of death and a major cause of disability worldwide. Both modifiable and non-modifiable risk factors can affect the occurrence of ischemic stroke at varying degrees. Among them, atherosclerosis has been well-recognized as one of the main culprits for the rising incidence of stroke-related mortality. Hence, the current review aimed to summarize the prominent role of lipid metabolism genes such as PCSK9, ApoB, ApoA5, ApoC3, ApoE, and ABCA1 in mediating ischemic stroke occurrence.

Matched MeSH terms: Cause of Death
Natural bioactive compounds as a new source of promising G protein-coupled estrogen receptor (GPER) modulators: comprehensive in silico approach

Khan SU, Ahemad N, Chuah LH, Naidu R, Htar TT

J Biomol Struct Dyn, 2020 Oct 15.
PMID: 33054574 DOI: 10.1080/07391102.2020.1830853

Cancer ranks in second place among the cause of death worldwide. Cancer progress in multiple stages of carcinogenesis and metastasis programs through complex pathways. Sex hormones and their receptors are the major factors in promoting cancer progression. Among them, G protein-coupled estrogen receptor-1 (GPER) has shown to mediate cellular signaling pathways and cancer cell proliferation. However, the lack of GPER protein structure limited the search for new modulators. In this study, we curated an extensive database of natural products to discover new potential GPER modulators. We used a combination of virtual screening techniques to generate a homology model of GPER and subsequently used that for the screening of 30,926 natural products from a public database to identify potential active modulators of GPER. The best hits were further screened through the ADMET filter and confirmed by docking analysis. Moreover, molecular dynamics simulations of best hits were also carried out to assess the stability of the ligand-GPER complex. This study predicted several potential GPER modulators with novel scaffolds that could be further investigated and used as the core for the development of novel GPER modulators.Communicated by Ramaswamy H. Sarma.

Matched MeSH terms: Cause of Death
Fulltext May Measurement Month 2019: an analysis of blood pressure screening results from Malaysia

Chia YC, Devaraj NK, Chook JB, Chew MT, Ooi PB, Mohamed M, et al.

Eur Heart J Suppl, 2021 May;23(Suppl B):B98-B100.
PMID: 34054370 DOI: 10.1093/eurheartj/suab058

Despite hypertension remaining the leading cause of death worldwide, awareness of hypertension and its control rate is still suboptimal in Malaysia. This study aims to determine the proportion of both diagnosed and undiagnosed hypertension, awareness and its control rate during the yearly May Measurement Month (MMM) campaign that has been coordinated by the International Society of Hypertension. Participants aged ≥18 years were recruited at various screening sites namely universities, health facilities, shopping malls, and other sites. Participant's socio-demographic, environmental, and lifestyle data were captured using a questionnaire. Three blood pressure (BP) readings as well as anthropometric measurements were obtained from all participants. The mean of the second and third BP readings was used in analyses. Hypertension was defined as a systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg or taking antihypertensive medication. A total of 3062 participants were recruited. The proportion with hypertension in our study was 18.7% (n = 572). The proportion who were aware of their BP status was 63.2%. More than half (57.2%) of the hypertensives were on antihypertensive medication and 70.3% of those treated were controlled. In conclusion, in this BP screening campaign, one in five were hypertensive with almost two thirds aware of their hypertensive status. BP control among those who are taking medications was high at 70% but under 60% of hypertensives were on treatment. Hypertension screening programmes are important to promote awareness and control of hypertension as well as to reduce the devastating complications associated with this disorder.

Matched MeSH terms: Cause of Death
Fulltext Malathion extraction from larvae of Chrysomya megacephala (Fabricius) (Diptera: Calliphoridae) for determining death due to malathion

Mahat NA, Jayaprakash PT, Zafarina Z

Trop Biomed, 2012 Mar;29(1):9-17.
PMID: 22543598 MyJurnal

The use of Chrysomya megacephala larvae for detecting malathion for diagnosing the cause of death was investigated. This could prove useful when the visceral organs have become liquefied during decomposition and therefore cannot be sampled. A field experiment was conducted in which C. megacephala were allowed to colonise naturally the corpses of rabbits that had died of malathion poisoning. The concentration of malathion increased gradually during the larval stages of C. megacephala reaching the maximum concentration in the third instar larvae. The concentration of malathion declined during prepupal stage and reached its lowest level among tenerals. The average malathion concentrations in C. megacephala growing in poisoned rabbit corpses left in a sunlit habitat were significantly higher (p<0.05) than those growing on poisoned rabbits left in a shaded habitat. The concentrations of malathion in the different stages of development of C. megacephala were moderately correlated (r = 0.51-0.69) with the administered doses as well as with those estimated in visceral organs. Thus, it would not be reliable to suggest the formulation of mathematical algorithms for relating the concentration of malathion found in the different stages of development of C. megacephala with those found in the visceral organs. However, in the context of forensic investigation, the qualitative detection of malathion in C. megacephala may prove useful in diagnosing the cause of death, since malathion is a common cause of accidental and suicidal deaths.

Matched MeSH terms: Cause of Death
Fulltext Prevalence of hypertension and its associated factors among university staff

Rampal, L., Somayeh, A. B., Salmiah, M. S., Faisal, I., Sharifah Zainiyah, S. Y.

Malaysian Journal of Medicine and Health Sciences, 2011;7(2):61-71.
MyJurnal

Introduction: In Malaysia, cardiovascular diseases (CVD) have been the leading cause of death for the past 40 years. Hypertension is the leading treatable risk factor for CVD mortality.
Objectives: to determine the prevalence and factors associated with hypertension among University Putra Malaysia staff.
Methods: A Cross sectional study design was used in this study. The sample was selected using table of random numbers. Two blood pressure measurements were taken from respondents aged 30 years and above. Data on socio-demographic variables and lifestyle-related risk factors were collected using a pre-tested structured questionnaire. Weight and height measurements were also taken.
Results: Out of 517 respondents selected, 454 subjects agreed to participate, giving a response rate of 87.8%. The overall mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) for 454 respondents was 126.2 mmHg and 80.17 mmHg respectively. The mean SBP was significantly higher in males (129.68 mmHg) as compared to the females (122.65 mmHg). The mean SBP and DBP significantly increased with age in both males and females (p<0.05). There was a significant relationship between SBP and BMI (r = 0.55, r2 = 0.30 p <0.001) and diastolic blood pressure and BMI (r = 0.53, r2 = 0.28, p <0.001). The overall prevalence of hypertension was 34.4% and 33.9% had pre hypertension. Hypertension was significantly associated with age, gender, family history of hypertension, BMI and alcohol consumption. Conclusions: Prevalence of hypertension and pre-hypertension is high. There is an urgent need for implementation of a comprehensive CVD prevention program. Routine blood pressure measurements should be taken to improve the detection, prevention and treatment of hypertension.
Keywords: Hypertension, Prevalence, Risk Factors, University Staff, Prevalence

Matched MeSH terms: Cause of Death

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