Sudden cardiac death in young adults may be associated with rare cardiomyopathies such as left ventricular noncompaction (LVNC) and arrhythmogenic right ventricular (ARVC) cardiomyopathies. LVNC is characterised by hypertrabeculations and deep recesses of the left ventricle. ARVC presents with thin myocardium as a result of extensive fibro-fatty infiltrations. In both conditions, death may be due to arrhythmia, thromboembolic events or heart failure. We report a case of a 21-year old athletic young man who collapsed at the futsal court right after the game. He was resuscitated but expired at the hospital after a brief admission. A week earlier, he had a similar episode of syncope and revived through cardio-pulmonary resuscitation at the site. Post mortem examination showed extensive acute myocardial infarction (AMI) involving the papillary muscles and the left ventricular wall. Features of LVNC were also observed. On top of that, the right ventricle showed patchy thin myocardium as the wall was largely comprised of fat. Histology examination confirmed the presence of AMI and massive fibro-fatty infiltrations of the right ventricle. This unfortunate young man had co-existing cardiomyopathies which is rare indeed. As he succumbed to AMI, this mechanism of death is also uncommonly associated with neither LVNC nor ARVC. In conclusion, young and physically active individuals may not be spared of sudden cardiac death. Mild and non-specific symptoms should not be taken lightly as it may be the subtle signs of cardiomyopathies.
Bone cement implantation syndrome (BCIS) is characterized by hypoxia, hypotension, cardiac arrhythmias, increased pulmonary vascular resistance and cardiac arrest. It is a known cause of morbidity and mortality in patients undergoing cemented orthopaedic surgeries. The rarity of the condition as well as absence of a proper definition has contributed to under-reporting of cases. We report a 59-year-old woman who sustained fracture of the neck of her left femur and underwent an elective hybrid total hip replacement surgery. She collapsed during surgery and was revived only to succumb to death twelve hours later. Post mortem findings showed multiorgan disseminated microembolization of bone marrow and amorphous cement material.
The Ministry of Higher Education in Malaysia has called for the implementation of a soft skills module in all public universities in Malaysia. In response to this and as part of curriculum development efforts for a new integrated program for 2011, a study was undertaken to improve the University of Malaya (UM) Faculty of Dentistry's communication skills course. One of the study objectives was to investigate dental students' attitudes towards communication skills learning and the association between their attitudes and demographic and education-related characteristics. A cross-sectional survey--using a self-administered twenty-four-item adapted Communication Skills Attitude Scale (CSAS) that contained both positive (PAS) and negative (NAS) attitude subscales--was carried out targeting all final-year dental students at the UM and the Universiti Kebangsaan Malaysia (UKM). A total of 148 students completed the survey, yielding a response rate of 88.1 percent. Overall, UKM students had significantly more positive attitudes towards communication skills learning (PAS score: mean=48.69, SD=4.48, p<0.001) than UM students (mean=46.03, SD=4.22). There was no statistically significant difference in negative attitudes between the two groups. UKM students with more positive attitudes tended to be female (p<0.05). UM students with more negative attitudes perceived themselves as poor communicators (p<0.05), and UKM students with more negative attitudes tended to have poor English proficiency (p<0.05). This study found that both UM and UKM final-year dental students have positive and negative attitudes towards learning communication skills. These attitudes were significantly associated with certain background and education-related attributes. Outcomes of this study served as a valuable guide in strengthening the communication skills course for the UM's new, integrated dental curriculum.
The objective of this two year retrospective study is to find out the pattern of ovarian tumours among Malaysian women. A total of 280 cases were reviewed. Of these 193 were benign, 81 were malignant and six cases belonged to borderline malignancy. In the general population, equal distribution of serous and mucinous tumours among the benign (15.4%) and malignant (4.3%) types is quite a striking feature. The teratomas were the commonest benign tumour among the Malays and Chinese. Serous cystadenomas were the commonest among the Indians. The Malays had higher incidence of malignant epithelial tumours whereas the Chinese had a higher incidence of metastatic and germ cell tumours. Endometroid tumours occurred from an earlier age of thirty years. There was a preponderance of mucinous tumours among the borderline variety.