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Stroke mortality variations in South-East Asia: empirical evidence from the field

Hoy DG, Rao C, Hoa NP, Suhardi S, Lwin AM

Int J Stroke, 2013 Oct;8 Suppl A100:21-7.
PMID: 23013164 DOI: 10.1111/j.1747-4949.2012.00903.x

Stroke is a leading cause of death in Asia; however, many estimates of stroke mortality are based on epidemiological models rather than empirical data. Since 2005, initiatives have been undertaken in a number of Asian countries to strengthen and analyse vital registration data. This has increased the availability of empirical data on stroke mortality.
Fulltext Synthesis and evaluation of selected 1,3,4-oxadiazole derivatives for in vitro cytotoxicity and in vivo anti-tumor activity

Tiwari A, Gopalan Kutty N, Kumar N, Chaudhary A, Vasanth Raj P, Shenoy R, et al.

Cytotechnology, 2016 Dec;68(6):2553-2565.
PMID: 27282155 DOI: 10.1007/s10616-016-9979-9

The oxadiazole moiety is known for its anticancer activity through its antiangiogenic and mitostatic potential. Taking this as a cue, the present study was designed to investigate the anti-cancer potential of selected oxadiazole derivatives. Twelve 1,3,4-oxadiazole derivatives (AMK OX-1 to AMK OX-12) were synthesized and were tested for IC50values through brine shrimp lethality assay and MTT assay on HeLa and A549 cell lines. Four compounds, AMK OX-8, 9, 11 and 12 showed potential cytotoxicity activity with low IC50value. These compounds produced considerable cytotoxic effect on Hep-2 and A549 cancer cell lines. However, they were found to be comparatively safer to normal cell lines, viz., V-79 cell lines than to the tested cancer cell lines, such as HeLa, A 549, and Hep2 cell lines. The mechanism of cytotoxicity was evaluated through nuclear staining and DNA ladder assay. Although DNA ladder assay showed DNA fragmentation (apoptotic phenomenon) in Hep-2 cells treated with only AMK OX-12, the staining procedures using acridine orange, ethidium bromide and propidium iodide showed apoptotic bodies in cells treated with AMK OX-8, 9 and 12 also. In JCI staining on isolated mitochondria of Hep2 cells, AMK OX-8, 9-11 and 12 displayed increasing fluorescence intensity with time which confirmed involvement of mitochondrial pathway and intrinsic pathway of apoptosis. All four compounds were found to be safe in acute oral toxicity study in Swiss albino mice. These derivatives were effective in reducing tumor size and weight in the in vivo DLA-induced solid tumor model. They were found to be significantly effective in reducing tumor volume and tumor weight.
Fulltext Validation of verbal autopsy: determination of cause of deaths in Malaysia 2013

Ganapathy SS, Yi Yi K, Omar MA, Anuar MFM, Jeevananthan C, Rao C

BMC Public Health, 2017 08 11;17(1):653.
PMID: 28800758 DOI: 10.1186/s12889-017-4668-y

BACKGROUND: Mortality statistics by age, sex and cause are the foundation of basic health data required for health status assessment, epidemiological research and formation of health policy. Close to half the deaths in Malaysia occur outside a health facility, are not attended by medical personnel, and are given a lay opinion as to the cause of death, leading to poor quality of data from vital registration. Verbal autopsy (VA) is a very useful tool in diagnosing broad causes of deaths for events that occur outside health facilities. This article reports the development of the VA methods and our principal finding from a validation study.
METHODS: A cross sectional study on nationally representative sample deaths that occurred in Malaysia during 2013 was used. A VA questionnaire suitable for local use was developed. Trained field interviewers visited the family members of the deceased at their homes and conducted face to face interviews with the next of kin. Completed questionnaires were reviewed by trained physicians who assigned multiple and underlying causes. Reference diagnoses for validation were obtained from review of medical records (MR) available for a sample of the overall study deaths.
RESULTS: Corresponding MR diagnosis with matched sample of the VA diagnosis were available in 2172 cases for the validation study. Sensitivity scores were good (>75%) for transport accidents and certain cancers. Moderate sensitivity (50% - 75%) was obtained for ischaemic heart disease (64%) and cerebrovascular disease (72%). The validation sample for deaths due to major causes such as ischaemic heart disease, pneumonia, breast cancer and transport accidents show low cause-specific mortality fraction (CSMF) changes. The scores obtained for the top 10 leading site-specific cancers ranged from average to good.
CONCLUSION: We can conclude that VA is suitable for implementation for deaths outside the health facilities in Malaysia. This would reduce ill-defined mortality causes in vital registration data, and yield more accurate national mortality statistics.
Fulltext Erratum to: Validation of verbal autopsy: determination of cause of deaths in Malaysia 2013

Ganapathy SS, Yi Yi K, Omar MA, Anuar MFM, Jeevananthan C, Rao C

BMC Public Health, 2017 08 31;17(1):687.
PMID: 28859634 DOI: 10.1186/s12889-017-4687-8
Fulltext Cause-specific mortality estimates for Malaysia in 2013: results from a national sample verification study using medical record review and verbal autopsy

Omar A, Ganapathy SS, Anuar MFM, Khoo YY, Jeevananthan C, Maria Awaluddin S, et al.

BMC Public Health, 2019 Jan 24;19(1):110.
PMID: 30678685 DOI: 10.1186/s12889-018-6384-7

BACKGROUND: Mortality indicators are essential for monitoring population health. Although Malaysia has a functional death registration system, the quality of information on causes of death still needs improvement, since approximately 30% of deaths are classified to poorly defined causes. This study was conducted to verify registered causes in a sample of deaths in 2013 and utilise the findings to estimate cause-specific mortality indicators for Malaysia in 2013.

METHODS: This is a cross-sectional study involving a nationally representative sample of 14,497 deaths distributed across 19 districts. Registered causes of deaths were verified using standard medical record review protocols for hospital deaths, and locally adapted international standard verbal autopsy procedures for deaths outside hospitals. The findings were used to measure the validity and reliability of the registration data, as well as to establish plausible cause-specific mortality fractions for hospital and non-hospital deaths, which were subsequently used as the basis for estimating national cause-specific mortality indicators.

RESULTS: The overall response rate for the study was 67%. Verified causes of 5041 hospital deaths and 3724 deaths outside hospitals were used to derive national mortality estimates for 2013 by age, sex and cause. The study was able to reclassify most of the ill-defined deaths to a specific cause. The leading causes of deaths for males were Ischaemic Heart Disease (15.4%), Cerebrovascular diseases (13.7%), Chronic Obstructive Pulmonary Disease (8.5%) and Road Traffic Accident (8.0%). Among females, the leading causes were Cerebrovascular diseases (18.3%), Ischaemic Heart Disease (12.7%), Lower Respiratory Infections (11.5%) and Diabetes Mellitus (7.2%).

CONCLUSIONS: Investigation of registered causes of death using verbal autopsy and medical record review yielded adequate information to enable estimation of cause-specific mortality indicators in Malaysia. Strengthening the national mortality statistics system must be made a priority as it is a core data source for policy and evaluation of the public health and healthcare sectors in Malaysia.
Erratum to "The histology of ovarian cancer: Worldwide distribution and implications for international survival comparisons (CONCORD-2)" [Gynecol. Oncol. 144 (2017) 405-413]

Matz M, Coleman MP, Sant M, Chirlaque MD, Visser O, Gore M, et al.

Gynecol Oncol, 2017 Jul 05.
PMID: 28687170 DOI: 10.1016/j.ygyno.2017.06.032