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Stertor and position

Simon MF

Lancet, 1901;158:417.
DOI: 10.1016/S0140-6736(01)85242-9
Matched MeSH terms: Asphyxia
Asphyxia from defective ship-board ventilation

Brooke GE

Lancet, 1916;188:18.
DOI: 10.1016/S0140-6736(01)26402-2
Matched MeSH terms: Asphyxia
Fulltext Completed suicides in the district of timur laut, penang island - a preliminary investigation of 3 years (2007-2009) prospective data

Bhupinder S, Kumara TK, Syed AM

Med J Malaysia, 2010 Jun;65(2):123-6.
PMID: 23756796

This article describes the completed suicide patterns which occurred in the Timur Laut district of Penang Island, Malaysia. In a prospective cohort study over the three years period (2007-2009) there were 138 cases of suicide deaths. The number of suicide deaths for the year 2007, 2008 and 2009 were 45, 41 and 52 deaths, respectively. Majority of the suicide deaths were by jumping from height (47.1%), followed by hanging (34.1%) and by drowning (10.9%). The male victims outnumbered females in a 3 : 1 ratio.

Matched MeSH terms: Asphyxia*
Acupuncture for hypoxic ischemic encephalopathy in neonates

Sibrecht G, Wong MY, Shrestha R, Bruschettini M

Cochrane Database Syst Rev, 2024 Dec 18;12:CD007968.
PMID: 39692246 DOI: 10.1002/14651858.CD007968.pub3

BACKGROUND: Peripartum asphyxia affects three to five per 1000 live births, with moderate or severe hypoxic ischemic encephalopathy (HIE) occurring in 0.5 to 1 per 1000 live births, and is associated with high mortality and morbidity. Therapeutic hypothermia is an effective treatment, but alternative therapies such as acupuncture are also used.
OBJECTIVES: To determine the benefits and harms of acupuncture (e.g. needle acupuncture with or without electrical stimulation; laser acupuncture; non-penetrating types of manual or embedded acupressure) on mortality and morbidity in neonates with HIE, compared with 1) no treatment, 2) placebo or sham treatment, 3) any pharmacologic treatment, or 4) different types of acupuncture.
SEARCH METHODS: We searched CENTRAL, PubMed, Embase, ClinicalTrials.gov, and the WHO ICTRP in March 2023. We conducted a search of the grey literature to identify reports of trials conducted by or referenced in research by CORDIS EU, National Institute for Health and Care Excellence (NICE), and NHSGGC Paediatrics for Health Professionals. We also checked the reference lists of relevant articles to identify additional studies.
SELECTION CRITERIA: We included randomized controlled trials (RCTs) or quasi-RCTs and cluster-randomized trials. We included studies where participants were term infants (37 weeks or greater) and late preterm infants (34 + 0 to 36 + 6 weeks' gestation) 10 days of age or less, with evidence of peripartum asphyxia. We included studies on acupuncture (e.g. needle acupuncture with or without electrical stimulation; laser acupuncture; non-penetrating types of manual or embedded acupressure). We included studies where acupuncture was compared with: 1) no treatment; 2) placebo or sham treatment; 3) any pharmacologic treatment; or 4) different types of acupuncture.
DATA COLLECTION AND ANALYSIS: We used standard Cochrane methods. Our primary outcomes were all-cause mortality at the latest follow-up, major neurodevelopmental disability in children aged 18 to 24 months and aged 3 to 5 years, adverse events until hospital discharge, and length of hospital stay.
MAIN RESULTS: We included four studies (enrolling 464 infants) that compared acupuncture with no treatment. The studies ranged in size from 60 to 200 infants. Three studies were conducted in China and one in Russia. None of the four studies reported on any of the prespecified outcomes of our review. We did not identify any ongoing studies.
AUTHORS' CONCLUSIONS: There is limited availability of studies addressing this specific population. The included studies did not assess mortality, long-term neurodevelopmental outcomes, or adverse effects of acupuncture. We are unable to draw any conclusions about the benefits and harms of acupuncture for HIE in neonates. In light of the current limitations, clinicians are urged to approach the use of acupuncture in neonates with HIE cautiously, as there is no evidence to support its routine application. The available trials assessed surrogate outcomes that have a relatively small impact on newborns, and failed to report important outcomes such as mortality and long-term neurodevelopmental outcomes. Other available trials were performed on older infants who had experienced neonatal HIE. Given the lack of available evidence, well-designed randomized controlled trials with relevant outcomes such as mortality and neurodevelopmental outcomes are essential to evaluate the efficacy and safety of acupuncture for HIE in neonates.

Matched MeSH terms: Asphyxia Neonatorum/complications; Asphyxia Neonatorum/mortality; Asphyxia Neonatorum/therapy
Motor vehicle-assisted ligature strangulation causing complete decapitation: an autopsy report

Samberkar PN

Am J Forensic Med Pathol, 2012 Mar;33(1):86-7.
PMID: 21455053 DOI: 10.1097/PAF.0b013e3182186d72

The victim, a 63-year-old prosperous businessman from Labasa, of the Northern Island (Vanua Levu) of Fiji Islands, was found completely decapitated in the early hours of morning in 2004. Initial police investigation did not reveal any history of any medical or family calamity. Further inquiry by the police revealed that on the previous day the deceased had visited all his friends and relatives, and his behavior was not out of the ordinary. The police suspected it to be a case of homicide. On visit to the scene, a completely decapitated body was found in a van on a downhill road. Tire marks were found on the road. A nylon rope was used for ligature strangulation. At autopsy, the decapitation wound of the head and the torso articulated well. The face was congested, and there was tongue bite. Wound margins were clear-cut, with well-demarcated abrasion and multiple imprints of the nylon rope on the neck. The upper one third of the larynx was attached to the head. No other injuries were found on the body. From the findings, it was obvious that asphyxiation was involved in the death before decapitation.

Matched MeSH terms: Asphyxia/etiology*; Asphyxia/pathology
Hanging without knot in the noose

Kumar V

J Forensic Leg Med, 2007 Jan;14(1):35-8.
PMID: 16530454

Death by hanging is believed to be a painless method of committing suicide. In most cases the noose has a knot and on this basis only it can be labeled as atypical or typical hanging. A 35 year Chinese man committed suicide by hanging with a ligature material made of electric wire where there was no knot present on the noose.

Matched MeSH terms: Asphyxia/etiology*; Asphyxia/pathology
Two cases of death due to plastic bag suffocation

Nadesan K, Beng OB

Med Sci Law, 2001 Jan;41(1):78-82.
PMID: 11219130

Deaths due to plastic bag suffocation or plastic bag asphyxia are not reported in Malaysia. In the West many suicides by plastic bag asphyxia, particularly in the elderly and those who are chronically and terminally ill, have been reported. Accidental deaths too are not uncommon in the West, both among small children who play with shopping bags and adolescents who are solvent abusers. Another well-known but not so common form of accidental death from plastic bag asphyxia is sexual asphyxia, which is mostly seen among adult males. Homicide by plastic bag asphyxia too is reported in the West and the victims are invariably infants or adults who are frail or terminally ill and who cannot struggle. Two deaths due to plastic bag asphyxia are presented. Both the autopsies were performed at the University Hospital Mortuary, Kuala Lumpur. Both victims were 50-year old married Chinese males. One death was diagnosed as suicide and the other as sexual asphyxia. Sexual asphyxia is generally believed to be a problem associated exclusively with the West. Specific autopsy findings are often absent in deaths due to plastic bag asphyxia and therefore such deaths could be missed when some interested parties have altered the scene and most importantly have removed the plastic bag. A visit to the scene of death is invariably useful.

Matched MeSH terms: Asphyxia/etiology; Asphyxia/pathology*
Fulltext End of life decision: we are not playing god?

Wan Khairina, W.M.N., Ngow, H.A.

International Medical Journal Malaysia, 2013;12(2):67-70.
MyJurnal

Advances in neonatal care now enable more infants to be kept alive despite clear clinical evidence of inevitable or imminent death on a life-support system. It is therefore no longer acceptable to the society that a patient is left to die in the hospital, without any form of treatment or intervention. We report a case of severe birth asphyxia, hypoxic-ischemic encephalopathy, neonatal seizures and left cephalohematoma. In spite of initial successful resuscitation, the infant could not survive until all possible methods of treatment were exhausted. This case illustrates one of many examples of the process involved in dealing with ending of life decision in a condition considered as futile.

Matched MeSH terms: Asphyxia; Asphyxia Neonatorum
Fulltext The usefulness of early ultrasonography, electroencephalography and clinical parameters in predicting adverse outcomes in asphyxiated term infants

Ong LC, Kanaheswari Y, Chandran V, Rohana J, Yong SC, Boo NY

Singapore Med J, 2009 Jul;50(7):705-9.
PMID: 19644627

The early identification of asphyxiated infants at high risk of adverse outcomes and the early selection of those who might benefit from neuroprotective therapies are required. A prospective observational study was conducted to determine if there were any early clinical, neuroimaging or neurophysiological parameters that might predict the outcome in term newborns with asphyxia.

Matched MeSH terms: Asphyxia Neonatorum/diagnosis*; Asphyxia Neonatorum/pathology*; Asphyxia Neonatorum/ultrasonography*
Performance of Combined Support Vector Machine and Principal Component Analysis in recognizing infant cry with asphyxia

Sahak R, Mansor W, Lee YK, Yassin AM, Zabidi A

Annu Int Conf IEEE Eng Med Biol Soc, 2010;2010:6292-5.
PMID: 21097359 DOI: 10.1109/IEMBS.2010.5628084

Combined Support Vector Machine (SVM) and Principal Component Analysis (PCA) was used to recognize the infant cries with asphyxia. SVM classifier based on features selected by the PCA was trained to differentiate between pathological and healthy cries. The PCA was applied to reduce dimensionality of the vectors that serve as inputs to the SVM. The performance of the SVM utilizing linear and RBF kernel was examined. Experimental results showed that SVM with RBF kernel yields good performance. The classification accuracy in classifying infant cry with asphyxia using the SVM-PCA is 95.86%.

Matched MeSH terms: Asphyxia Neonatorum/diagnosis*
Condom-murder

Murty OP

J Forensic Leg Med, 2009 Jan;16(1):35-9.
PMID: 19061848 DOI: 10.1016/j.jflm.2008.05.017

Condom-murder is term used to describe a homicide where a person has been killed due to his recreational sexual behaviour and the killing has strong links with the recovered condom/contraceptive material on the scene or was in personal possession of victim. It can provide immediate clue about perpetrator. We present six cases of a similar nature. Four males and two females had condoms in their vicinity at crime scene. All incidents occurred at different timings and different places but there was striking similarity in method of killing. In four cases hands were tied on the back in three cases; similarly legs were also tied in three cases. In three cases strong electric cords were used. The presence of condoms give clue for investigation, possibility of DNA identification, about type of sexual behaviour as recreational and commercial method in these cases.

Matched MeSH terms: Asphyxia/pathology
The effect of thyroxine on the renal function of asphyxiated neonates

Rostenberghe, H.V., Haider, D., Abdullah, Y., Amir, H., Abdul Razak, A.R.

Malaysian Journal of Paediatrics and Child Health, 1998;10(2):19-23.
MyJurnal

Thyroxine has been shown to have a beneficial effect on renal function in cases of impending renal failure in ani-mal studies.'5 Studies of the use of thyroxine in humans in impending renal failure are scarce. The aim of this study was to assess the effect of oral thyroxine on the renal function of asphyxiated term neonates who often have renal impairment.
A randomised control trial was conducted, involving 30 term asphyxiated neonates. The study group (n=15) was given thyroxine (50 pg) orally on days 1, 2 and 3 of life and placebo was given to the control group (n=15). Renal function was studied on day 1 and day 4 of life. The two groups did not differ significantly as regards gestational age, birth weight, severity of asphyxia, preg-nancy or delivery complications, fluids administered and drugs used. There was no significant difference in urine output, creatinine clearance and fractional excretion of sodium on day 1 but there was a trend towards a worse renal function on day 1 in the treatment group. The creatinine clearance was significantly better in the treat-ment group on day 4 (p = 0.017). Urine output and fractional excretion of sodium on day 4 were better in the treatment group but the differences did not reach statistical significance (p = 0.14 and 0.057 respectively). Statistical analysis on the differences between day 4 and day 1 showed statistical significance only for creatinine clearance: creatinine clearance day 4 minus creatinine clearance day 1 was 52.6 (±32.4) for the thyroxine group and 7.3 (±7.8) for the controls (p= 0.006).
These data support the hypothesis that thyroxine may have a significant beneficial effect on the renal function in term neonates with perinatal asphyxia. Thyroxine may be proven useful in future for patients with impending renal failure.

Matched MeSH terms: Asphyxia; Asphyxia Neonatorum
Fulltext Unilateral Congenital Choanal Atresia: A Rare Missed Cause of Chronic Nasal Discharge

Wan Nur Anis Wan Draman, Addina Mat Baki, Hashimah Ismail, Shamina Sara Moses, Irfan Mohamad

Malaysian Journal of Paediatrics and Child Health, 2020;26(1):14-20.
MyJurnal

Choanal atresia is an uncommon malformation of the upper airway. Bilateral choanal atresia usually detected earlier as it is often associated with severe asphyxia immediately after birth. The diagnosis is often delayed in unilateral type, and mostly presented with unilateral chronic nasal discharge. This condition is rarely encountered but should be considered as a possible differential diagnosis of persistent nasal discharge. We present a case of unilateral congenital choanal atresia in a 4-month-old baby girl presented with persistent unilateral nasal discharge. Diagnostic investigation and possible surgical treatment techniques were discussed.

Matched MeSH terms: Asphyxia
Choking on food: a rare case of alexander leukodystrophy and choking

Murty OP, Mun K, Gopinath N, Wong KT

Am J Forensic Med Pathol, 2008 Dec;29(4):364-7.
PMID: 19259028 DOI: 10.1097/PAF.0b013e3181859ff7

Every body has to eat to survive but it becomes a matter of great concern, when the life provider food becomes an asphyxiating agent. In this case, a 60-year-old woman choked herself while swallowing biscuits. On autopsy examination, biscuits were found lodged in larygo-pharynx. Brain showed marked dystrophy and loosened lusterless white matter. On histopathologic examination, brain tissue had numerous eosinophilic globules representing astrocytic processes called "Rosenthal fibers"; hence, it was diagnosed as a case of Alexander dystrophy. It is a disease of white matter, where there is a progressive degeneration of the white matter of the brain because of imperfect growth or development of the myelin sheath. The histopathology of brain showed Rosenthal fibers in abundance. This is one of the rarest disease in which choking can occur because of lack of nervous and muscular coordination and weakness. Its specific relation to choking is documented in this report.

Matched MeSH terms: Asphyxia/etiology*; Asphyxia/pathology
Fulltext Ingestion of a voice-master prosthesis followed by a potentially fatal aspiration

Philip R, Imran AG, Dinsuhaimi S, Shahid H

Med J Malaysia, 2006 Jun;61(2):233-5.
PMID: 16898319 MyJurnal

Various complications are associated with the use of indwelling voice prostheses. We present problems faced by a patient with his Voice-Master prosthesis, the ingestion of the prosthesis followed by a potentially fatal aspiration. The Voice-Master is unique in that in can be re-inserted. The safety strap is removed after primary insertion once the prosthesis is secure. However, during re-insertions this safety mechanism is no longer present. Therefore we recommend the placement of a temporary stitch or tie to minimize the risks of ingestion or aspiration of the prosthesis during re-insertions.

Matched MeSH terms: Asphyxia/etiology*; Asphyxia/surgery
Asphyxia screening kit

Zabidi A, Khuan LY, Mansor W

Annu Int Conf IEEE Eng Med Biol Soc, 2012;2012:1298-301.
PMID: 23366136 DOI: 10.1109/EMBC.2012.6346175

Infant asphyxia is a condition due to insufficient oxygen intake suffered by newborn babies. A 4 to 9 million occurrences of infant asphyxia are reported each year by WHO. Early diagnosis of asphyxia is important to avoid complications such as damage to the brain, organ and tissue that could lead to fatality. This is possible with the automation of screening of infant asphyxia. Here, a non-invasive Asphyxia Screening Kit is developed. It is a Graphical User Interface that automatically detects asphyxia in infants from early birth to 6 months from their cries and displays the outcome of analysis. It is built with Matlab GUI underlied with signal processing algorithms, capable of achieving a classification accuracy of 96.03%. Successful implementation of ASK will assist to screen infant asphyxia for reference to clinicians for early diagnosis. In addition, ASK also provides an interface to enter patient information and images to be integrated with existing Hospital Information Management System.

Matched MeSH terms: Asphyxia Neonatorum/diagnosis*; Asphyxia Neonatorum/physiopathology
Comparison of serum cardiac troponin T and creatine kinase MB isoenzyme mass concentrations in asphyxiated term infants during the first 48 h of life

Boo NY, Hafidz H, Nawawi HM, Cheah FC, Fadzil YJ, Abdul-Aziz BB, et al.

J Paediatr Child Health, 2005 Jul;41(7):331-7.
PMID: 16014136

This prospective study aimed to compare serum creatine kinase MB isoenzyme (CK-MB) mass concentrations and cardiac troponin T (cTnT) concentrations during the first 48 h of life in asphyxiated term infants.

Matched MeSH terms: Asphyxia Neonatorum/blood*; Asphyxia Neonatorum/enzymology
Early cranial ultrasound changes as predictors of outcome during first year of life in term infants with perinatal asphyxia

Boo NY, Chandran V, Zulfiqar MA, Zamratol SM, Nyein MK, Haliza MS, et al.

J Paediatr Child Health, 2000 Aug;36(4):363-9.
PMID: 10940172

OBJECTIVES: To identify the types of early cranial ultrasound changes that were significant predictors of adverse outcome during the first year of life in asphyxiated term infants.
METHODOLOGY: This was a prospective cohort study. Shortly after birth, cranial ultrasonography was carried out via the anterior fontanelles of 70 normal control infants and 104 asphyxiated infants with a history of fetal distress and Apgar scores of less than 6 at 1 and 5 min of life, or requiring endotracheal intubation and manual intermittent positive pressure ventilation for at least 5 min after birth. Neurodevelopmental assessment was carried out on the survivors at 1 year of age.
RESULTS: Abnormal cranial ultrasound changes were detected in a significantly higher proportion (79.8%, or n = 83) of asphyxiated infants than controls (39.5%, or n = 30) (P < 0.0001). However, logistic regression analysis showed that only three factors were significantly associated with adverse outcome at 1 year of life among the asphyxiated infants. These were: (i) decreasing birthweight (for every additional gram of increase in birthweight, adjusted odds ratio (OR) = 0.999, 95% confidence interval (CI) 0.998, 1.000; P = 0.047); (ii) a history of receiving ventilatory support during the neonatal period (adjusted OR = 8.3; 95%CI 2.4, 28.9; P = 0.0009); and (iii) hypoxic-ischaemic encephalopathy stage 2 or 3 (adjusted OR = 5.8; 95%CI 1.8, 18.6; P = 0.003). None of the early cranial ultrasound changes was a significant predictor.
CONCLUSIONS: Early cranial ultrasound findings, although common in asphyxiated infants, were not significant predictors of adverse outcome during the first year of life in asphyxiated term infants.

Matched MeSH terms: Asphyxia Neonatorum/mortality*; Asphyxia Neonatorum/physiopathology*
Fulltext Post mortem caesarian section

Ravindran J

Med J Malaysia, 1995 Sep;50(3):284-5.
PMID: 8926913
Matched MeSH terms: Asphyxia Neonatorum
Microplankton bloom in a brackish water lagoon of Terengganu

Shamsudin L, Shazili NA

Environ Monit Assess, 1991 Oct;19(1-3):287-94.
PMID: 24233946 DOI: 10.1007/BF00401318

Increased primary plankton productivity was observed in a brackish water lagoon of Terengganu during the study period between January 1988 to December 1988. The lagoon is also the site for the fish cage culture activities of sea bass during the study period. An examination of water quality at the sampling stations during the study period indicated that both the organic and inorganic nutrients were high during the pre-monsoon period. The source of the nutrient in the lagoon was believed to be derived from the agro-based industrial effluents, fertilisers from paddy fields as well as untreated human and animal wastes. This coincided with the peak production of plankton in the surface waters of the brackish water lagoon. During this period both cultured and indigenous fish species were seen to suffer from oxygen asphyxiation (suffocation due to lack of oxygen). The primary productivity values ranged from 9 to 22 μg/L/h during the peak period while the microplankton species were composed of diatom, flagellates and dinoflagellates. Reduction in the primary productivity values were obtained with reduction in sallinity, specially during the peak monsoon months (November to March) corresponding to the Northeast monsoon period.

Matched MeSH terms: Asphyxia

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