Diesel is commonly used as fuel for engines and is distilled from petroleum. Diesel has toxic potential and can affect multiple organs. Exposure can occur after ingestion, inhalation or through the dermal route. The practice of siphoning diesel using a rubber tubing and the mouth is common in rural communities. This can lead to accidental ingestion and aspiration. Here we report a case of a patient who accidentally ingested diesel during siphoning, which caused extensive erosion of the oral cavity and oesophagus leading to pneumomediastinum and severe chemical lung injury. The patient responded well initially to steroids and supportive care but required prolonged hospitalisation. He developed complications of nosocomial infection and succumbed 23 days after admission.
Mediastinal Emphysema ; Lung Injury

Objective: To investigate the anti-inflammatory effects of the total flavonoids from Saussurea involucrata on lipopolysaccharides (LPS)-stimulated murine RAW264.7 macrophages and explore its underlying mechanism of action. Methods: Total flavonoids from Saussurea involucrata were extracted using chromatographic column method. Cell viability was determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide assay. The production of nitric oxide was detected by Griess assay and the release of cytokines (IL-10 and TNF-α) and chemokines (MCP-1, MIP-1a, and CCL5/RANTES) was determined by ELISA to evaluate the anti-inflammatory activity of total flavonoids from Saussurea involucrata. Moreover, nuclear translocation of p65, c-Jun, and IRF3 was detected by immunofluorescence microscopy and Western blotting analysis was performed to determine the expression of related proteins. Results: Total flavonoids extracted from Saussurea involucrata were 751.5 mg/g and the content of rutin was 506.5 mg/g. The production of inflammatory mediators including nitric oxide, cytokines, and chemokines was effectively inhibited by total flavonoids from Saussurea involucrata. Meanwhile, total flavonoids also suppressed the nuclear translocation of p65, c-Jun, and IRF3 in LPS-stimulated RAW264.7 cells. The LPS-induced expression of iNOS and COX-2 was remarkably reduced by treatment with total flavonoids from Saussurea involucrata. Moreover, total flavonoids decreased the expression levels of p-IKKa/β, p-TBK1, p-p38, p-ERK, p-JNK, p-p65, p-c-Jun, and p-IRF3 in LPS-exposed RAW264.7 macrophages. Conclusions: Total flavonoids from Saussurea involucrata potentially inhibit the secretion of pro-inflammatory mediators, which may be related to inhibition of p65, c-Jun, and IRF3 signaling pathways in LPS-stimulated RAW264.7 cells.

BACKGROUND

Cardiovascular disease (CVD) is a group of disorders of the heart and blood vessels, which includes coronary heart disease, cerebrovascular disease, and peripheral artery disease. It is currently the leading cause of death worldwide. Currently, there is paucity in the available epidemiologic data of CVD in Southeast Asia (SEA).

OBJECTIVE

To determine the prevalence, mortality rate, and associated risk factors of CVD (specifically ischemic heart disease, stroke, and peripheral artery disease) among adult populations in SEA.

METHODS

A systematic review of published articles between 2015 and 2020 was conducted. The authors also searched the World Health Organization database and publicly available health department websites of Southeast Asian countries.

RESULTS

The overall prevalence of CVDs in SEA is 5.48%. Specifically, the prevalence of ischemic heart disease is 1.54% and is highest in Thailand (2.54%). Ischemic stroke has a prevalence of 1.03% and is highest in Indonesia (1.97%). Prevalence of peripheral artery disease is 1.36% and is also highest in Thailand (1.92%). Mortality rate from CVD in SEA is 13.41%. Hypercholesterolemia, smoking, and hypertension are the most common risk factors, with prevalence of 41.2%, 21.1%, and 20.9%, respectively.

CONCLUSION

The prevalence and mortality rate of CVD in SEA remain high and are associated with high prevalence of underlying risk factors. Interventions should be strengthened to improve the overall picture in the region. Collaborative efforts among Southeast Asian countries are essential not only in generating comparative epidemiologic data but also in sharing best practices in lowering CVD mortality and morbidity.

Cardiovascular Diseases ; Myocardial Ischemia ; ischemic heart disease ; Stroke ; Peripheral Arterial Disease ; Risk Factors ; Asia, Southeastern