Lung, Liver and Skin Changes in an Infant with Positive Methamphetamine.

BACKGROUND: The increased use of illicit drugs continues to lead to the discovery of various unexpected pathologies. CASE PRESENTATION: This 7-month-old infant died suddenly at home. Pulmonary artery fibrinoid necrosis, diffuse fatty liver changes, and skin rash were the main histologic postmortem findings. Postmortem urine contained traces of methamphetamine. Methamphetamine was smoked by the parents. CONCLUSIONS: Fibrinoid necrosis has been described with inhaling methamphetamine and can result in fibrinoid angiitis such as in this case. Although this did not result in pulmonary hemorrhage or could be directly related to death, it does suggest that pulmonary artery fibrinoid necrosis may develop with passive inhalation of methamphetamines.

Suicide in the elderly in Malaysia.

Suicidal feelings and a sense of hopelessness have been regarded as part of the ageing process more so in the context of being elderly and having physical difficulties. As older adults are the fastest growing population in the world, suicides among this population is also expected to increase. The authors retrospectively reviewed all cases recorded by the National Suicide Registry Malaysia (NSRM) for the year 2009. Suicide in victims 65 years and older totaled 23 in number and accounted for 7.1% of all suicides. All the cases were autopsied. The case records were retrospectively analyzed with respect to age, gender, ethnicity and method of death. Comparisons were also made between males and females, levels of education, presence of stressor and life events antecedent to suicide. The ages of these suicide victims ranged from 65 to 94 years. Men comprised almost 70% of the cases. The average age of the victim was 73 years. Hanging was the most common method of suicide, accounting for 56.5% of the cases. Other methods included jumping from height (13.1%), exposure to unspecified chemicals (13.1% ), jumping/lying before moving object (4.3%), exposure to pesticides (4.3%) and injuring oneself using sharp object (4.3%). Death of a loved one, legal problems, financial problems and physical illness were the stressors identified contributing to the suicide act.

Pattern of suicides in 2009: data from the National Suicide Registry Malaysia.

INTRODUCTION: The National Suicide Registry Malaysia (NSRM) is a nationwide system that captures data on completed suicides in Malaysia from all forensic departments under the purview of the Ministry of Health Malaysia. METHODS: This paper examines all suicidal deaths reported to the NSRM from 1 January 2009 to 31 December 2009. The relevant variables were recorded in the paper-based Case Report Form (CRF) and then entered into the online reporting system for analysis. RESULTS: The overall suicide rate for 2009 was 1.18 per 100,000 population (n = 328). The age range was 14-94 years, with a median of 37 (IQR 24) years. There were more men than women, the gender ratio being 2.9:1 (males : females), and the majority (89% or 293/328) were Malaysian citizens. Ethnicity-wise, Indians had the highest suicide rate of 3.67 per 100,000. The Malays and Bumiputera of Sabah and Sarawak had lower rates of 0.32 to 0.37 per 100,000. Mental illness was reported in 22% (72/328) of the cases and physical illnesses in 20.4% (67/328). Previous suicide attempts were reported in 15.5% (51/328) of cases. History of substance abuse was present in 28.7% (83/328). Life events were positive in 41.2% (135/328) of cases. DISCUSSION: Malaysia is able to generate statistics on suicide by enhancing the collaboration between forensic, psychiatry and clinical research agencies. These trends should be monitored to gain a better understanding of suicide trends.