Modern medicine, specifically assisted reproductive technology (ART), has overtaken the law in many jurisdictions around the world. New technologies and practices open a Pandora's Box of ethical, religious, social and legal questions, and may present a variety of significant legal problems to the courts and legislators. Surrogate motherhood and pregnancy through ART have both attracted controversy. Some groups condemn ART and want it banned while its supporters acknowledge there is a need for legislative guidelines and regulations. A proposed statute, the Assisted Reproductive Technique Services Act, aimed at regulating reproductive technologies, including surrogacy arrangements, will be introduced in the Malaysian parliament, probably in 2012, and the Assisted Reproductive Technology (Regulation) Bill 2010 is already before the Indian parliament. This paper will discuss several of the potential socio-legal issues surrounding ART in the light of the complex situation, with a comparative analysis of the Malaysian, USA, UK and Indian positions.
The prevalence of ischaemic heart disease with associated cardiomegaly and other chronic diseases such as diabetes mellitus has increased in Malaysia in recent years. As the contribution to mortality from ischaemic heart disease/cardiomegaly in different ethnic populations is unclear, a three year (January 2013-December 2015) retrospective study of autopsy cases was undertaken at the Department of Forensic Pathology, University Malaya Medical Centre. There were 80 cases with lethal ischaemic heart diseases/cardiomegaly. The age range was 30-69 years (mean 50.19 years) with a male to female ratio of 39:01. The most vulnerable age was 50-59 years accounting for 38.75% of cases. Malays accounted for 15% of cases, Indians for 32.5% and Chinese for 36.25%. Although in 35 cases (43.75%) there was a history suggestive of ischaemic heart disease, the remaining 45 cases (56.25%) were apparently healthy until the terminal collapse. It appears that Indian males in the 50-59 year age range are most at risk for lethal cardiac events in this population, most often with no preceding symptoms or signs. The study demonstrates the value of studying subpopulations for disease risk rather than relying on accrued general population data.
We investigated the development of third molars among Malaysians (including variations between jaws and genders) using Demirjian's method. Dental panoramic radiographs of 1224 subjects aged 8 to 24 years were examined, and the molars were assigned Demirjian et al.'s development grades (A-H). Results indicated that 18.8% had congenitally missing or extracted third molars. Development of molars begins earlier in females (also in the mandible), but by age 9, male children's molar development speeds up with more advanced grades in their middle teens than females. Grade C indicates the subject is a juvenile, while initiation of root development (Grade E), was observed from 13 years on. Grade H can occur in a child aged 18 years who technically is still a juvenile. We compared the development and growth patterns of the third molar from both the maxilla and the mandible.
The vast majority of GP appointments had to move from in-person to remote consultation during the pandemic. Rather than phasing this out now that the threat of the coronavirus has begun to ebb, the UK government has announced that digital-first primary care will continue for the foreseeable future. While remote consultation can be beneficial on several fronts, it can compromise professional identity, therapeutic alliance, patient safety and access to healthcare. A hasty push towards normalising digitally-enabled care may therefore increase the risk of misdiagnoses, medical negligence, unnecessary referrals and health inequity. To enhance the gains and iron out the challenges associated with IT-led triage and consultations, it is important to reflect on the lessons learned from the pandemic.