Due to globalizing trend of homogenisation of culture, changes in the health care delivery system and market economics infringing on the practice of medicine, there has been a gradual shift in the attitude of the medical community as well as the lay public towards greater acceptance of euthanasia as an option for terminally ill and dying patients. Physicians in developing countries come across situations where such issues are raised with increasing frequency. As the subject has gained worldwide prominence, we want to review this topic from Islamic perspective due to its significance in medical ethics and clinical practice.

Background and Objectives: Despite much medical progress, stroke remains a leading cause of death and disability. The aim of our study was to analyze the frequency of various risk factors and determine predictors of in-hospital mortality among primary intracerebral hemorrhage (PICH) patients, thus providing insight in developing therapeutic strategies to improve the outcome. Methods: A prospective study conducted at a tertiary care hospital. Results: A total of 160 patients (108 male and 52 female) were evaluated. Their ages ranged from 25 to 85 years (mean age was 58.3 ± 11.4 years). Hypertension was the commonest risk factor (74.4%), followed by diabetes mellitus (18.8%) and cigarette smoking (36.3%). The commonest location of ICH was lobar (43.8%) followed by basal ganglia / internal capsule (28.1 %) and multilobar (13.1%). The overall in-hospital mortality was 32.5 %. About one third (32.7%) of the deaths occurred within fi rst 24 hours, this rose to 38.5% within fi rst 2 days and 84.6% within one week. The signifi cant independent predictors of acute in- hospital mortality were Glasgow Coma Scale (GCS) on admission, posterior fossa bleed (OR 11.01; 95% CI 3.21 to 37.81), hematoma volume >60ml (OR 4.72; 95% CI 1.34 to 16.64), mid line shift (OR 3.32; 95% CI 1.05 to 10.50) and intraventricular extension of haemorrhage (OR 5.69; 95% CI 2.24 to 14.47). Conclusion: Low GCS score, posterior fossa bleed, and large hematoma volume were main indicators of mortality following PICH in East coast of Peninsular Malaysia.