Sudden cardiac death (SCD) continues to be a major health issue in many countries including Malaysia due to its large magnitude in all-cause mortality as well as the emotional and socioeconomic impact of the deceased leaving the love ones behind in an abrupt manner. Data in Malaysia shows that the majority of sudden natural deaths are due to sudden cardiac death and are in the productive age group of 41 to 50 years. A study in Germany pointed out that about 90% people who died of SCD actually had warning signs such as chest pain, breathlessness, nausea, vomiting, dizziness and fainting before they collapsed. The majority belonged to the high-risk group for SCD having had previous medical histories including coronary artery disease, cardiomyopathies, valvular heart disease, congenital heart disease, underlying electrophysiological abnormalities or are taking drugs which are capable of provoking ventricular tachyarrhythmias. The key step is to define a sequence of risk stratifiers that will identify patients who are at risk but in whom implantation of expensive devices will be cost-effective. Amongst the investigative tools proven to be helpful to achieve this are ECG screening for left ventricular hypertrophy, increased QRS width, T-wave alternans, heart rate variability, baroreceptor responsiveness, QT dispersion, and T-wave heterogeneity; Holter monitoring to demonstrate ventricular arrhythmias; and stress test in identifying ischaemia. Prompt action is crucial since restoring circulation as fast as possible improves the chances of survival. Family members and caregivers of people with heart disease and at increased risk should be trained to recognize symptoms and perform cardiopulmonary resuscitation (CPR) to reduce the likelihood of death from cardiac arrest. Training and prevention efforts should focus on how to recognize the emergency, CPR training, and automated external defibrillator (AED) use. An implantable cardioverter-defibrillator (ICD) is the preferred therapeutic modality in most survivors of SCD. The incidence of SCD can be reduced by improving the current situation through selection of high risk groups for initiation of therapies, education to the public awareness of early warning symptoms and early emergency management that should be readily available in the community.
Anemia, Sickle Cell ; Death, Sudden, Cardiac ; Risk ; Cardiopulmonary Resuscitation ; symptoms <1>

Pesticide exposure can lead to low trace elements levels in human body. Trace element plays important role in body metabolism. The aim of this study was to study the levels of selenium, zinc and chromium among paddy farmers who expose to pesticide in Wilayah I, MADA, Perlis. This cross sectional study involved 70 males paddy farmers and 57subjects living in fisherman village as control group who were aged between 21 to 80 years old. Subjects were interviewed to obtain information on their demographic data by using validated questionnaire. Subjects also were examined for their blood pressure and glucose level. Selenium, zinc and chromium levels were analyzed by using acid digestion method and Inductively Coupled Plasma Mass Spectrometry (ICP-MS). Results showed that selenium levels in hairs (5.11 ± 17.05 μg/L) and nails (4.92 ± 2.17 μg/L) were significantly (p < 0.05) lower compared to selenium levels in hairs (15.67 ± 10.59 μg/L) and nails (6.67 ± 2.81 μg/L) in control group. Chromium levels in hairs (31.83 ± 15.17 μg/L) and nails (87.64 ± 23.30 μg/L) were also significantly lower (p < 0.05) compared to chromium levels in hairs (85.19 ± 56.90 μg/L) and nails (99.36 ± 56.89 μg/L) of control group. However there were no significant different (p>0.05) between all trace element levels and duration of pesticide exposures. In conclusion, levels of trace elements were lower in nails and hairs of paddy farmers than fisherman community group