After-Hours Care ; Attitude of Health Personnel ; Attitude to Health ; Child ; Cross-Sectional Studies ; Emergency Service, Hospital ; utilization ; Humans ; Medical Overuse ; Parents ; Pediatrics ; Primary Health Care ; Singapore ; Surveys and Questionnaires

INTRODUCTIONA retrospective case series of acute anterior myocardial infarction (MI) patients complicated by complete atrioventricular block (AVB) treated with acute percutaneous transluminal coronary angioplasty (PTCA).

CLINICAL PICTUREEight patients with anterior MI and complete AVB underwent acute PTCA between 2000 and 2005. Mean onset of complete AVB was 16.6 +/- 16.9 hours from chest pain onset.

TREATMENTAll patients underwent successful PTCA to the left anterior descending artery.

OUTCOMEComplete AVB resolved with PTCA in 88%; mean time of resolution was 89 +/- 144 minutes after revascularisation. One patient had permanent pacemaker implanted at Day 12 after developing an 8-second ventricular standstill during hospitalisation but not pacing-dependent on follow-up. The rhythm on discharge for the other surviving patients was normal sinus rhythm.

CONCLUSIONThis case series suggests that complete AVB complicating anterior MI is reversible with acute PTCA and survivors are not at increased risk of recurrent AVB. Nevertheless, this condition is associated with extensive myocardial damage and high mortality during the acute hospitalisation was not improved with correction of AVB with temporary pacing.

Adult ; Aged ; Angioplasty, Balloon, Coronary ; Anterior Wall Myocardial Infarction ; complications ; therapy ; Atrioventricular Block ; complications ; therapy ; Electrocardiography ; Female ; Humans ; Male ; Middle Aged ; Recovery of Function ; Retrospective Studies

Background: The public health issue of consuming groundwater is a major concern because people often extract groundwater directly from the aquifers either through wells or boreholes without treating it with any form of filtration system or chlorine disinfection. Based on the Malaysian National Drinking Water guidelines the current study was designed to provide a better understanding on the variable factors that are influencing the quality of well-water in an urbanised village in Malaysia. Well water quality assessment of heavy metals, chemicals, microbial and physical parameters were carried out for Sungai Buloh Village in the Klang Valley to ensure it was safe for human consumption. Materials and Methods: Water samples were collected from wells at four sites (Sites A,B,C,D), a river and a tap inside a house in Sungai Buloh village. Soil was sampled from the riverbed and area surrounding the wells. Samples were collected every two months over a one year duration from all sites. The water samples were processed and examined for viruses, coliforms and protozoa as well as for heavy metal contaminants. Results: The turbidity and colour ranged in the average of 0.57-0.13 Nephelometric Turbidity (NTU) and 4.16- 5.00 Total Conjunctive Use (TCU) respectively for all sites except Site C. At Site C the turbidity level was 2.56 ± 1.38 NTU. The well-water was polluted with coliforms (1.2 to 2.4 x 10 3 CFU/100 ml) in all sites, E. coli (0.12 - 4 x 10 2 CFU/100 ml CFU/ 100 ml) and Cryptosporidium oocysts (0.4 cysts/100 ml). All the heavy metals and chemical parameters were within the Malaysian Guidelines’ limits except manganese. The average pH ranged from 5.44 - 6.62 and the temperature was 28 ºC. Conclusion: In summary, the well water at Sungai Buloh is considered unsafe for consumption due to pollution. Therefore the major thrust will be to provide better quality of drinking water to the residents of the village.

Objective: To explore the anti-cancer activity of maslinic acid against colorectal cancer (CRC) cell lines and its possible mechanism. Methods: The inhibitory effect of maslinic acid was screened against five CRC cell lines (HT-29, HCT 116, SW480, SW48, and LS 174T) via 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. Apoptosis and cell cycle analyses were carried out using annexin V-FITC/propidium iodide staining and propidium iodide staining, respectively and subjected to fluorescence-activated cell sorting analysis. Protein expression studies of inhibitor of κB kinase-β (IKK-β), checkpoint kinase 1 (Chk1) and cyclin D1 were conducted using the JESS system. Results: Maslinic acid exhibited growth inhibitory effect in a doseand time-dependent manner in HT-29 and HCT 116 cell lines. A more prominent apoptosis induced by maslinic acid was observed in HCT 116 cell line. However, in HT-29 cell line, maslinic acid induced cell cycle arrest by inhibiting the G1-S transition, which was accompanied by the downregulation of cyclin D1. The expression of unphosphorylated IKK-β protein was increased in both (HT-29 and HCT 116) cell lines after maslinic acid treatment. Conclusions: Maslinic acid inhibits the growth of HT-29 and HCT 116 cells in a different manner, induces cell cycle arrest in HT-29 cells and causes apoptosis in HCT 116 cells partially via NF-κB pathway inhibition.