MyMedR

A systematic approach to death registration and reporting is essential for studies and comparison within or between countries. One of the accepted methods in the system is to have medically certified death. The objective of this study was to improve the proportion of medically certified death (MCD) in the state of Malacca. Structured questionnaires were used by Medical Assistants (MAs) in the investigation of the cause of death for non-medically certified deaths. Data on certification of death by MAs in Malacca was analysed and compared with the total deaths obtained from the Department of Statistics. Possible determinants of deaths were investigated. Total deaths in the state of Malacca during the study period from 2000 - 2001 were 5941. About 35% (883/2493) of the total deaths in year 2000 and 45% (1550/3448) in 2001 certified by MAs were examined. By districts, 50.6% were certified in the district of Malacca Tengah, 13.4% Jasin and 36.0% Alor Gajah in 2000; 65.9% occurred in Malacca Tengah, 11.0% Jasin and 23.2% Alor Gajah in 2001. This project helped to increase the percentage of the medically certified deaths in Malacca from 49.8% in year 1998, 49% in 1999 to 73% in 2000 and 85% in 2001. The proportion of MCD in Malacca in 2000 (73%) may be increased to 93% if all MCDs done by MAs were accepted by the Department of Statistics. There is still a high proportion (23.6%) of ill-defined conditions such as old age and sudden death being diagnosed by MAs. The study shows that the quality of mortality data particularly in the percentage of medically certified deaths can be improved.

Matched MeSH terms: Cause of Death*

Maternal deaths

LLEWELLYN-JONES D

Med J Malaya, 1958 Sep;13(1):103-8.

PMID: 13589379

Matched MeSH terms: Maternal Death*

The prevention of maternal death

LLEWELLYN-JONES D

Med J Malaya, 1957 Jun;11(4):291-9.

PMID: 13482565

Matched MeSH terms: Maternal Death*

Fulltext Traumatic diaphragmatic herniation following esophageal intubation in neonatal death

Tan LJ, Zainun KA, Koh CP

Pediatr Neonatol, 2024 Jan;65(1):91-93.

PMID: 37658028 DOI: 10.1016/j.pedneo.2023.05.005

Matched MeSH terms: Perinatal Death*

Longitudinal Follow-Up of Death Anxiety and Psychophysical-Symptom Experience of Participants in the Silent Mentor Program

Wong LP, Tan SL, Alias H, Sia TE, Saw A

Omega (Westport), 2023 Nov;88(1):157-170.

PMID: 34490819 DOI: 10.1177/00302228211043613

This study assessed death anxiety (Death Anxiety Questionnaire, DAQ) and psychophysical- (psychological and physical) symptom experience following cadaveric dissection among the Silent Mentor Program (SMP) participants before thawing (T1), after the suturing, dressing and coffining session (T2), and one month post-program (T3). There was a significant decline in the total DAQ score comparing T1 and T2 (t = 7.69, p death and psychophysical-symptom experience associated with cadaver dissection.

Matched MeSH terms: Attitude to Death; Death*

The linkage between microRNA and cancer and its delivery as cancer therapy: A mini-review

Syed Najmuddin SUF, Kamarudin AA, Abdul Sani S, Norrrahim MNF, Abdul Latif N', Wah LGP

Cell Mol Biol (Noisy-le-grand), 2023 Jul 31;69(7):7-18.

PMID: 37715444 DOI: 10.14715/cmb/2023.69.7.2

The central dogma of molecular biology was no longer "central" after ground-breaking discoveries conveyed gene expression involves more complex physiological functions in cancer pathogenesis over the last decade. MicroRNAs (miRNAs) are short non-coding RNA that regulate gene expression, affecting key molecular pathways involved in sustaining the proliferative signalling for tumour development, evasion of cellular death, invasion, angiogenesis, as well as metastasis in a plethora of cancer types. MiRNA expression is dysregulated in human cancer through a number of processes, including miRNA gene amplification or deletion, faulty miRNA transcriptional regulation, dysregulated epigenetic alterations, and flaws in the miRNA biogenesis machinery. As a result, the current progress of treatment intervention focuses on modifying the miRNA levels in cancer therapeutics. Nevertheless, the mode of delivery and current management of miRNA therapies remains one of the many questions that need to be addressed. Here, we provided a comprehensive mini-review outlining the role of miRNA in cancer as well as its mode of delivery which includes liposomes, viral vectors, inorganic material-based nanoparticles, and cell-derived membrane vesicles. Likewise, the regulation of miRNA in other diseases and their challenges in translational research was also thoroughly discussed.

Matched MeSH terms: Cell Death

Fulltext Risk factors for pneumonia among patients with Parkinson's disease: a Taiwan nationwide population-based study

Chang YP, Yang CJ, Hu KF, Chao AC, Chang YH, Hsieh KP, et al.

Neuropsychiatr Dis Treat, 2016;12:1037-46.

PMID: 27175081 DOI: 10.2147/NDT.S99365

Pneumonia is the leading cause of death in patients with Parkinson's disease (PD). However, few studies have been performed to explore the risk factors for pneumonia development in patients with PD.

Matched MeSH terms: Cause of Death; Death

Fulltext Therapeutic intervention scoring system in medical intensive care (letter)

Delilkan AE

Med J Malaysia, 1989 Dec;44(4):361-2.

PMID: 2520051

Comment on: Adam BA, Kin LC, Wahab AS. Therapeutic intervention scoring system in medical intensive care. Med J Malaysia. 1989 Jun;44(2):134-9

Matched MeSH terms: Brain Death/diagnosis*

Fulltext Diagnosis and management of brain death

Namazie M

Med J Malaysia, 1980 Jun;34(4):363-7.

PMID: 7219264

The diagnosis and management of brain death is discussed in this paper. Criteria recommended by the Conference of Medical Royal Colleges and their Faculties in U.K. were used in the diagnosis of brain death. It is felt that brain death should be considered as death of the individual and a plea is made to draw up guidelines on management of patients with brain death.

Matched MeSH terms: Brain Death*; Death

Post mortem troponin T analysis in sudden death: Is it useful?

Rahimi R, Dahili ND, Anuar Zainun K, Mohd Kasim NA, Md Noor S

Malays J Pathol, 2018 Aug;40(2):143-148.

PMID: 30173231 MyJurnal

INTRODUCTION: Cardiac-related diseases contributed approximately 50-60% of sudden natural death cases. This study aimed to describe the cardiac troponin T (cTnT) findings in post mortem subjects irrespective of the cause and manner of death, and the possible use of post mortem serum cTnT as a modality in investigating sudden natural death.

METHODS: The study samples comprised 140 subjects aged 18 to 50 years old, natural and unnatural causes of sudden death brought to the Department of Forensic Medicine, Hospital Sungai Buloh (HSgB) and Hospital Sultanah Aminah Johor Bahru (HSAJB) for a period of 12 months. The subjects were categorised into 5 groups: cardiovascular disease (CVD), sudden unexplained death (SUD), thoracic trauma (TT), non-thoracic trauma (NTT) and other diseases (OD).

RESULTS: Median troponin concentration in cases of CVD, SUD, TT, NTT, and OD were 0.51 μg/L, 0.17 μg/L, 0.62 μg/L, 0.90 μg/L and 0.51 μg/L respectively. We found no significant difference of troponin T level in different causes of death (p ≥ 0.05). NTT has the highest median troponin concentration with 0.90 μg/L, SUD possessed the lowest median concentration with 0.17 μg/L.

CONCLUSION: Troponin T is neither specific nor useful as cardiac biomarker for post mortem sample. Therefore, it may not be a useful diagnostic tool at autopsy.

Matched MeSH terms: Cause of Death; Death, Sudden*

Autopsy findings of SUDEP in adolescence

Afandi D, Romus I

Malays J Pathol, 2018 Aug;40(2):185-189.

PMID: 30173237

Sudden unexpected death in epilepsy (SUDEP) is a rare in children; the risk of SUDEP in children is up to 10-fold less than adults. Herein, we report a case of SUDEP in a 14-year-old boy. The post-mortem findings in neuropathological examination in SUDEP are not pathognomonic. Tongue and lip bites marks are only an indication of a seizure before death. Basically, there are no lesions that could explain the incidence of seizures before death. However, post-mortem examination is mandatory in order to determine the diagnosis of SUDEP. Autopsy, histopathological, and toxicologic examinations and a proper medical history of epilepsy are required to come to diagnosis of SUDEP. This case report further demonstrates the importance of medicolegal autopsy in allegedly dead victims.

Matched MeSH terms: Death, Sudden/etiology*; Death, Sudden/pathology*

Fulltext A sudden paediatric death due to hand, foot and mouth disease: the importance of vigilance

Rahimi R, Omar E, Tuan Soh TS, Mohd Nawi SFA, Md Noor S

Malays J Pathol, 2017 Aug;39(2):167-170.

PMID: 28866699 MyJurnal

BACKGROUND: Hand, foot and mouth disease (HFMD) is caused by enteroviruses such as Coxsackie virus A16 (CVA16) and Enterovirus 71 (EV71). The diagnostic hallmarks are oral ulcers and maculo-papular or vesicular rash on the hands and feet. Severe form of this disease can lead to death due to neurological and cardiopulmonary complications. This case report aims to describe a fatal case of HFMD with minimal oral and skin manifestations.
CASE REPORT: A four-year-old girl was brought to a hospital after suddenly becoming unresponsive at home. She had a history of fever and lethargy for three days prior to her demise. The patient, and f ive other children in her neighbourhood had been diagnosed to have HFMD at a local health clinic; the other children had recovered without complications.
RESULTS: Autopsy revealed a few punctate, sub-epidermal vesicles measuring 1 to 2 mm on the palm of her right hand and sole of the right foot, visible only with a magnifying glass. Internal examination revealed prominent nodularity at the oro- and hypopharynxes. The lungs were markedly congested and oedematous. Histopathology of the lung showed marked oedema and haemorrhage with mild pneumonic changes. Oedema with increase in macroglia and astrocytic proliferation were seen in the cerebral tissue, but no lymphocytic infiltration was evident. Enterovirus EV71 was detected by polymerase chain reaction in samples from the lung, cerebrospinal fluid and serum. The cause of death was given as HFMD complicated by pneumonia.
CONCLUSION: Fatal HFMD may have minimal signs. A complete history, careful physical examination and relevant investigations lead to a diagnosis at post mortem examination. Awareness of the subtle signs and rapid deterioration associated with a fatal case of HFMD is a challenge to clinicians who encounter these cases.

Matched MeSH terms: Death, Sudden/etiology*; Death, Sudden/pathology

Regional disparities and risk factors of mortality among patients at high risk of sudden cardiac death in emerging countries: a nonrandomized controlled trial

Zhao S, Ching CK, Huang D, Liu YB, Rodriguez-Guerrero DA, Hussin A, et al.

BMC Med, 2024 Mar 22;22(1):130.

PMID: 38519982 DOI: 10.1186/s12916-024-03310-5

BACKGROUND: Comprehensive data on patients at high risk of sudden cardiac death (SCD) in emerging countries are lacking. The aim was to deepen our understanding of the SCD phenotype and identify risk factors for death among patients at high risk of SCD in emerging countries.

METHODS: Patients who met the class I indication for implantable cardioverter-defibrillator (ICD) implantation according to guideline recommendations in 17 countries and regions underrepresented in previous trials were enrolled. Countries were stratified by the WHO regional classification. Patients were or were not implanted with an ICD at their discretion. The outcomes were all-cause mortality and SCD.

RESULTS: We enrolled 4222 patients, and 3889 patients were included in the analysis. The mean follow-up period was 21.6 ± 10.2 months. There were 433 (11.1%) instances of all-cause mortality and 117 (3.0%) cases of SCD. All-cause mortality was highest in primary prevention (PP) patients from Southeast Asia and secondary prevention (SP) patients from the Middle East and Africa. The SCD rates among PP and SP patients were both highest in South Asia. Multivariate Cox regression modelling demonstrated that in addition to the independent predictors identified in previous studies, both geographic region and ICD use were associated with all-cause mortality in patients with high SCD risk. Primary prophylactic ICD implantation was associated with a 36% (HR = 0.64, 95% CI 0.531-0.802, p

Matched MeSH terms: Death, Sudden, Cardiac/epidemiology; Death, Sudden, Cardiac/prevention & control

Fulltext Perinatal postmortem: factors influencing uptake and subsequent outcomes in an Asian population

Valayatham V, Hiu J

Med J Malaysia, 2012 Feb;67(1):87-90.

PMID: 22582555 MyJurnal

To assess uptake of perinatal postmortems (PM) among mothers experiencing perinatal deaths. Subjective assessment of factors influencing uptake was studied. Analysis of perinatal PM outcomes and its impact on cause analyses of intrauterine fetal demise was made.

Matched MeSH terms: Fetal Death/etiology

The importance of the medico-legal autopsy

Nadesan K

Malays J Pathol, 1997 Dec;19(2):105-9.

PMID: 10879249

All deaths due to unnatural causes and deaths that are believed to be due to natural causes but where the medical cause of death is not certain or known are subjected to an inquest. The objective of an inquest is to ascertain facts pertaining to the death. This is achieved by inquiry and at the conclusion of the inquest a verdict is arrived as to whether the death was due to a natural, accidental, suicidal or a homicidal cause. An inquest is not a trial. There is no complainant or defendant and at the conclusion of the inquest no judgment is passed. The inquest system exists in all parts of the world. In the English legal system, the person who conducts an inquest is called a Coroner. In Scotland, he is called a Procurator Fiscal. The United States of America use the Medical Examiner system. Most continental European countries and their former colonies follow the Code Napoleon. A postmortem examination may become necessary in certain deaths that come up for inquests. In these situations the authority which conducts the inquest will order a doctor to perform a postmortem examination (medico-legal autopsy). To perform a medico-legal autopsy, consent from the relatives of the deceased is not required. In an unexpected sudden death, only a doctor after a postmortem examination may be able to determine the cause of death. However, it is often wrongly assumed that the objective of a postmortem examination is only to ascertain the cause of death. This article deals with the purpose of the inquest and roles of the medico-legal autopsy.

Matched MeSH terms: Cause of Death*

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