We describe a rare case of aorto-oesophageal fistula and aortic pseudoaneurysm in a middle-aged man, who presented with chest pain and haematemesis 1 week after swallowing a fish bone. Oesophagogastroduodenoscopy and computed tomographic angiography findings were consistent with oesophageal perforation, proximal descending aortic pseudoaneurysm, and aorto-oesophageal fistula. Thoracic endovascular aortic repair was performed. The patient died from severe mediastinal sepsis. Early surgical intervention and broad-spectrum antibiotic therapy are crucial in preventing life-threatening mediastinal infection.
Hypertension can be caused by various factors while the predominant causes include increase in body fluid volume and resistance in the circulatory system that elevate the blood pressure. Consumption of probiotics has been proven to attenuate hypertension; however, the effect is much strain-dependent. In this study, a newly isolated Lactobacillus casei (Lb. casei) strain C1 was investigated for its antihypertensive properties in spontaneously hypertensive rats (SHR). Lactic acid bacteria (LAB) suspension of 11 log colony-forming unit (CFU) was given to SHR (SHR+LAB, n=8), and phosphate buffer saline (PBS) was given as a control in SHR (SHR, n=8) and in Wistar rats as sham (WIS, n=8). The treatment was given via oral gavage for 8 weeks. The results showed that the weekly systolic blood pressure (SBP), mean arterial pressure (MAP), diastolic blood pressure (DBP) and aortic reactivity function were remarkably improved after 8 weeks of bacterial administration in SHR+LAB. These effects were mostly attributed by restoration of wall tension and tensile stress following the bacterial treatment. Although not statistically significant, the level of malondialdehye (MDA) in SHR+LAB serum was found declining. Increased levels of glutathione (GSH) and nitric oxide (NO) in SHR+LAB serum suggested that the bacterium exerted vascular protection through antioxidative functions and relatively high NO level that induced vasodilation. Collectively, Lb. casei strain C1 is a promising alternative for hypertension improvement.
This is the first report of Synthesiomyia nudiseta (Wulp) (Diptera: Muscidae) on a human corpse discovered in a high-rise building in Malaysia. On 5 March 2008, a decomposing body of an adult female was found on the top floor of a thirteen-story building in Kuala Lumpur, Malaysia. Her body was colonized by S. nudiseta larvae, which were normally associated with corpses found indoors at ground level. The post-mortem interval (PMI) was estimated at approximately 5 to 9 days. This case is significant as it demonstrates that this species can locate a dead body even in a high-rise building. Further findings of fly distribution especially in high-rise buildings should be reported to assist entomologists in PMI analysis.
This study reviews forensic entomological specimens analysed by the Department of Parasitology & Medical Entomology, Universiti Kebangsaan Malaysia for the year 2004. A total of 10 cases (6 males and 4 females) were observed for the entomological specimens. Various types of death scenes were obtained including indoor and outdoor area such as bushes field, rubbish dumping site, and aquatic areas. Identified fly species collected from the death sites were blow flies, Chrysomya megacephala, Chrysomya rufifacies and Lucilia cuprina and unknown sarcophagid larvae, with Ch. megacephala being the most common species found in the ecologically varied death scene habitats. The post-mortem interval (PMI) estimation ranged from one to five days, based on the entomological specimens collected.
Insects found associated with corpse can be used as one of the indicators in estimating postmortem interval (PMI). The objective of this study was to compare the stages of decomposition and faunal succession between a partially burnt pig (Sus scrofa Linnaeus) and natural pig (as control). The burning simulated a real crime whereby the victim was burnt by murderer. Two young pigs weighed approximately 10 kg were used in this study. Both pigs died from pneumonia and immediately placed in an oil palm plantation near a pig farm in Tanjung Sepat, Selangor, Malaysia. One pig was partially burnt by 1-liter petrol while the other served as control. Both carcasses were visited twice per day for the first week and once thereafter. Adult flies and larvae on the carcasses were collected and later processed in a forensic entomology laboratory. Results showed that there was no significant difference between the rate of decomposition and sequence of faunal succession on both pig carcasses. Both carcasses were completely decomposed to remain stage after nine days. The species of flies visiting the pig carcasses consisted of blow flies (Chrysomya megacephala, Chrysomya rufifacies, Hemipyrellia ligurriens), flesh fly (Sarcophagidae.), muscid fly (Ophyra spinigera), soldier fly (Hermetia illucens), coffin fly (Phoridae) and scavenger fly (Sepsidae). The only difference noted was in the number of adult flies, whereby more flies were seen in the control carcass. Faunal succession on both pig carcasses was in the following sequence: Calliphoridae, Sarcophagidae, Muscidae, Phoridae and lastly Stratiomyidae. However, there was overlap in the appearance of members of these families. Blowflies continued to oviposit on both carcasses. Hence postmortem interval (PMI) can still be estimated from the partially burnt pig carcass.
Forensic entomology refers to the science of collection and analysis of insect evidence in order to determine the minimum time period since death. This study aimed to investigate the occurrence of forensically important flies on 34 human remains referred to Universiti Kebangsaan Malaysia Medical Centre over a period of three years. Entomological specimens were collected at the death scenes and/or during autopsies. Live specimens were reared into adults while preserved specimens were processed for species identification. Five families, seven genera and nine species of flies were identified from human remains. The results of the study showed Chrysomya megacephala (Calliphoridae) maggots occurred on corpses with the highest frequency (70.6%), followed by Ch. rufifacies (Calliphoridae) (44.1%), sarcophagid fly (Sarcophagidae) (38.2%), Synthesiomya nudiseta (Muscidae) (20.6%), Megaselia scalaris (Phoridae) (14.7%), Lucilia cuprina (Calliphoridae) (5.9%), Ch. nigripes (Calliphoridae) (5.9%), Eristalis spp. (Syrphidae) (5.9%) and Hydrotaea spinigera (Muscidae) (2.9%). The greatest fly diversity occurred on remains recovered indoors (eight species) compared to outdoors (three species). Whilst, single and double infestations were common for both indoor and outdoor cases, multiple infestation of up to six species was observed in one of the indoor cases. Although large numbers of fly species were found on human remains, the predominant species were still those of Chrysomya, while S. nudiseta was found only on human remains recovered from indoors. The present study provides additional knowledge in the context of Malaysian forensic entomology and the distribution of forensically important flies which is of relevance to forensic science.