<b>INTRODUCTIONb>Exercise-related cardiac arrest is uncommon, however it is devastating when it occurs in otherwise healthy adults. This study aims to identify the characteristics of exercise-related cardiac arrest in the study population and estimate the overall survival rate.

<b>MATERIALS AND METHODSb>This is a retrospective observational study of exercise-related cardiac arrest in Singapore. Patients with exercise-related out of hospital cardiac arrest (OHCA) were selected from the Cardiac Arrest and Resuscitation Epidemiology (CARE) database, which is a prospective cardiac arrest registry, derived from ambulance records, emergency department and hospital discharge records. Patient characteristics, cardiac arrest circumstances and outcomes were studied.

<b>RESULTSb>Fifty-fi ve cases of exercise-related cardiac arrests were identified from December 2001 to January 2008. Mean age was 50.9 years with a male predominance of 96.4%. Eighty percent of the exercise-related cardiac arrests were witnessed, however only 58.2% of the patients received bystander cardiopulmonary resuscitation (CPR). The fi rst presenting rhythm was ventricular fibrillation (VF) in 40% of the patients, followed by asystole (38.2%). Of 96.2% of the patients who died from cardiac causes, coronary artery disease was the main etiology for 54%. The 30-day survival rate was 5.5%.

<b>CONCLUSIONb>We found that exercise-related cardiac arrest causes significant mortality in our community. Increased CPR training among the public, easy access to defibrillators and faster emergency medical service (EMS) response time could improve the outcome of exercise-related cardiac arrests. A comprehensive pre-participation screening for competitive exercises should be outlined for primary prevention of exercise-related cardiac arrest. A better reporting system for exercise-related cardiac arrest is needed.

Adolescent ; Adult ; Age Factors ; Aged ; Cardiopulmonary Resuscitation ; utilization ; Exercise ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Out-of-Hospital Cardiac Arrest ; epidemiology ; Retrospective Studies ; Singapore ; epidemiology ; Young Adult

The long agonistic protocol for controlled ovarian hyperstimulation (COH) is effective and used most often, thus is considered the gold standard. Therefore any new regimen has to be compared in its results with those obtained with the long protocol. This report compares the efficacy of GnRH agonist and antagonist in a retrospective study of IVF/ICSI carried out in a tertiary teaching hospital from 2003 to 2006. Only the first COH cycle followed by IVF-ICSI from 200 couples (agonist = 120 and antagonist = 80) were analysed. The end points studied included the number of oocytes recovered, number of mature (MII) oocytes, fertilization, cleavage, morphology based embryo quality, pregnancy rate, quantity and cost of gonadotrophin. The average age of female subjects was 35.1 +/- 4.7 years with 50% being 35 years and above. Major infertility factors were tubal blockage, male factor and endometriosis altogether comprising 68%. GnRH agonist and antagonist cycle parameters were comparable except lesser amount of gonadotrophin was used with lower resultant costs (both p < 0.0005) in antagonistic regime. Antagonist regime produce somewhat more good quality embryos (p = 0.065), an insignificant difference. A clinical pregnancy rate per embryo transfer of 16.3% in agonist and 20.6% in antagonist regime was achieved respectively. In conclusion, GnRH antagonist protocol produced a COH response, embryonic development and pregnancy rates on par to GnRH agonist regime. Moreover GnRH antagonist protocol required a shorter stimulation period plus fewer complications. Hence GnRH antagonist regime provided means for a friendlier, convenient and cost effective protocol for patients.
Gonadorelin ; Protocols documentation ; Pregnancy ; Encounter due to In vitro fertilization ; Sperm Injections, Intracytoplasmic

Background. Newborn screening (NBS) is a procedure for the immediate detection of genetic, metabolic, and endocrine disorders in neonates and is crucial for prompt treatment should such disorders be identified. In the Philippines, Republic Act 9288 requires health workers to properly inform mothers regarding NBS and its importance before the procedure.

Objective. To determine the knowledge, attitude, and awareness of primiparous postpartum mothers towards NBS Methods: A survey questionnaire was administered to primiparous mothers from Wards 15 and 16 of the Philippine General Hospital from April 11 through May 14, 2017. Results of primiparous postpartum mothers with or without previous prenatal check-ups were then compared.

Results. We surveyed 160 mothers, with half (56.3%) aged between 20 and 29 years. There were 149 mothers with and 11 without prenatal checkups. Mothers with previous prenatal checkups were more likely to be aware of NBS than those without prenatal checkups. Knowledge on NBS of mothers with previous prenatal checkups was higher on average compared to those without previous prenatal checkups. There was no significant difference in attitude between mothers with or without prenatal checkups.

Conclusion. Prenatal checkups increased the awareness and knowledge of primiparous mothers' towards NBS, and thus can be a potent vehicle where healthcare providers may inform the mother on the process and purpose of this procedure.

Neonatal Screening ; Knowledge ; Awareness ; Attitude

Purinergic P2Y Receptor Antagonists ; Consensus ; Cardiovascular System ; Cardiology ; Asia