Teen's death plunge: Suicide Over CCA

A 15-YEAR-OLD student leapt to his death after his parents tried to dissuade him from switching his co-curricular activity, a coroner's court heard.
Shortly before the incident on Feb 13, Tan Wen Yi had told his parents he had lost his inspiration to run and insisted on switching to drama.
At the end of the discussion, the Secondary 3 student of Anglo-Chinese School (Independent) said: 'In fact, I plan to do it in March but I am going to do it now.''

http://www.straitstimes.com/Breaking%2BNews/Singapore/Story/STIStory_307015.html

Full-time NSman collapsed and died after training activity

http://www.channelnewsasia.com/stories/singaporelocalnews/view/379403/1/.html
http://www.mindef.gov.sg/imindef/news_and_events/nr/2008/sep/30sep08_nr.html

So sad, another case of our NS man died during training.

"Private (PTE) Foo Wei Rong Joe, a Full-time National Serviceman from 4th Battalion, Singapore Infantry Regiment, collapsed in Lim Chu Kang Camp at 6.05 am this morning while doing chin-ups. The chin-ups, as well as some push-ups which he had completed earlier, were part of the unit's daily basic exercise routine. He was given immediate medical attention and evacuated to Tengah Medical Centre by 6.40am, where the doctors tried to resuscitate him. PTE Foo was sent to National University Hospital at 7.15 am. The SAF doctor and medic continued their attempts to resuscitate him en route to the hospital, and he arrived at 7.45am. PTE Foo was pronounced dead at 8.28am.MINDEF and the SAF extend their deepest condolences to the family of the late PTE Foo, and will assist the family in their time of grief. MINDEF is investigating the incident."

http://www.channelnewsasia.com/stories/singaporelocalnews/view/375844/1/.html

An example of adminstering someone with CPR when someone collapse.

"A 48-year-old man's in critical condition, after collapsing on Sunday morning inside the unopened Kallang-Paya Lebar Expressway.
This, during a race inside the tunnel to celebrate the completion of the 12-kilometre underground highway.
The man, identified as Mr Koh Sien Chin, was hired by the Land Transport Authority as the event's official photographer."
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"Mr Koh is now in critical condition at the Changi General Hospital. Kalai Chelvan, one of the runners, said: "We felt breathless when we were running, we know the heat is there."

Karoushi

過労死（かろうし）Karoushi
Gosh man! what is this. This is what we call Work Until You Die.

We can over work until we get killed. Well as I always say, there is a time to rest, work and everything. Shouldn't eat into each allocated time slot. If the the homeostasis mechanism will go bizarre.

http://en.wikipedia.org/wiki/Kar%C5%8Dshi

Karōshi (過労死, karōshi), which can be translated quite literally from Japanese as "death from overwork", is occupational sudden death. The major medical causes of karōshi deaths are heart attack and stroke due to stress.

Another person died in Japan from over work
http://www.straitstimes.com/print/Latest+News/Asia/STIStory_258932.html
http://sg.news.yahoo.com/rtrs/20080718/tap-oukwd-uk-japan-overwork-2ef4ed8.html
http://news.asiaone.com/News/Latest+News/Asia/Story/A1Story20080718-77560.html

July 18, 2008
Bereaved Japan mother angered by deadly overwork
TOKYO - A JAPANESE woman hit out at corporate bosses this week, after her restaurant manager son died of a brain haemorrhage having done 200 hours of overtime in a month.
The case is the latest of hundreds of deaths a year officially determined to have been caused by the hardships of working for Japanese companies, where overtime is a matter of course and holidays few and far between.

Aging

Aging comes about when the body starts loose it's ability to maintain its homeostasis. As life proceeds the body exposes itself to many mutantgenic agents. The body tries to cause apoptosis of such cells. As more and more mutant genes are being created, the body gradually ages. The ability for the body to repair gradually diminishes.

We must be thankful everyday that we are experiencing healing and recovery. We must thank your kidney that is its able to excrete waste and bring our blood chemistry into balance. Kidney effieciency drops as one ages. Because they wont be with you forever. In every aspect of life, bringing things to a restoration are the many principles. It's like the concept of Taiji(太极); to bring everything into balance.

In health, we give sufficient rest, nutrients to the body to restore. In relationship, we seek reconciliation with our love ones. In daily living, we alocate time for family, study, work rest and etc.

What is death?

What is death?
When a life ends, that is death. The cessation of biological functions in organism brings about death. Life begins with birth, growth,maturation and death. Not too sure if it is after matutration, senescence of the body starts. Bodily organs starts to retrograde, and eventually cease its function.

When you know it comes...
Rather common... a sudden surge of energy comes, like what some of them call last burst of fire. Some may loose control of their body's involuntary muscle, which may cause uncontrollable urination and defication.

The body fails to matains homeostasis, all matter will return to is equilibrium with nature.

• Pallor Mortis takes place, the hearts stops, blood stops circulating and body becomes pale.Happens 15 to 20 mins after death.
• Therefore livor mortis takes place, a settling of the blood in the lower (dependent) portion of the body. Its takes places 20min to 3 hours after death.Blood then starts to harden in 3 to 5 hours time. In 6 to 12 hours, purplish marks becomes obvious.
• Algor Mortis takes place.Thermoregulation of body stops, and body returns its heat to the surrounding and body cools down.
• Rigor Mortis takes place in 2 to 4 hours time. The body becomes stiff.
• Decompostion begins at the moment of death, caused by two factors: autolysis, the breaking down of tissue by the body's own internal chemicals and enzynes; and putrefaction, the breakdown of tissues by bacteria. These processes release gases that are the chief source of the characteristic odour of dead bodies. These gases swell the body.

Death

From ash, man is created; when his journey reaches the end, death sweeps him; he returns to ash.

生命是非常的脆弱。有没有想过，当人生走到了尽头，生后会是怎么样的。或是否生后存在。丧礼不是为了亡生者，但是为这活这的人。人亡生，是否还会有未来？活这的，为死者做再多的风光葬礼，也只不过如此。

他也许在也看不见。这只不过是为了安慰活这的。想想看，还真是个悲哀。当我们活在这每一刹那，我们应该要为周照的人献出爱和关怀；要牢牢记住，明天不知道会发生什么事。因为当他已离去，那天做的再多，致爱的人早已感受不到，一切都没有什么意义。

2/3 of SCD occur in over-60 age group

Extracted from:
http://www.channelnewsasia.com/stories/singaporelocalnews/view/358412/1/.html

Which age gp is more susceptible?
"Reports in recent years of fit and healthy young men collapsing and dying while exercising do not mean sudden cardiac deaths occur most in this age group. The reality is actually quite different, says Senior Parliamentary Secretary for Health, Hawazi Daipi. Less than 3 per cent of sudden cardiac death victims were below 35 years old. In fact, two-thirds of such cases involved victims above 60 years old. "

The below shows that CPR is very important for SCA. We now even have CPR instructions on Mobile!!
"Meanwhile, to improve survival rate in a cardiac arrest emergency situation, the Singapore Medical Association and the Singapore Heart Foundation have launched a Mobile Cardio Pulmonary Resuscitation (CPR) Download for handphones. "

IA for Sudden Cardiac Arrest

One of the immediate action one should take includes:

1. CPR
2. Defibrillation

And all this should be administered withing 7 minutes. Any treatment after would be deemed not very useful is nothing was done within 7 minutes.

Extract from American Heart Association

http://www.americanheart.org/presenter.jhtml?identifier=4741

"Brain death and permanent death start to occur in just four to six minutes after someone experiences cardiac arrest. Cardiac arrest is reversible in most victims if it's treated within a few minutes with an electric shock to the heart to restore a normal heartbeat. This process is called defibrillation. A victim's chances of survival are reduced by 7 to 10 percent with every minute that passes without CPR and defibrillation"

The below is an extract from Mayo Clinic

http://www.mayoclinic.com/health/sudden-cardiac-arrest/DS00764/DSECTION=8

"Immediate cardiopulmonary resuscitation (CPR) is critical to treating sudden cardiac arrest. By maintaining a flow of oxygen-rich blood to the body's vital organs, CPR can provide a vital link until more advanced emergency care is available

DefibrillationAdvanced care for ventricular fibrillation typically includes delivery of an electrical shock through the chest wall to the heart. The procedure, called defibrillation, momentarily stops the heart and the chaotic rhythm. This often allows the normal heart rhythm to resume.
The shock may be administered by emergency personnel or by a trained citizen if a public-use defibrillator, the device used to administer the shock, is available. If you're not trained to use an automatic external defibrillator (AED), a 911 operator may be able to guide you in its use. Trained staff members at many public places are able to provide and use an AED."

Risk Factors for Cardiac Arrest

Here are some risk factors found listed at Mayo Clinic

Extract from http://www.mayoclinic.com/health/sudden-cardiac-arrest/DS00764/DSECTION=4

In addition to a personal or family history of heart disease — including heart rhythm disorders, congenital heart defects, congestive heart failure and cardiomyopathy — other factors that may increase your risk of sudden cardiac arrest include:

1. Low output of blood from you heart (ejection fraction)
2. Previous episode of cardiac arrest
3. Previous heart attack
4. Markedly changed blood levels of potassium or magnesium — minerals called electrolytes that need to be properly balanced in order to maintain vital organ functions, including that of the heart
5. Hyperthyroidism, a condition in which your thyroid gland produces too much of the hormone thyroxine, speeding up your metabolism and potentially causing arrhythmia
   Pulmonary hypertension, a type of high blood pressure that affects the arteries in your lungs
6. Taking drugs that affect your heart rhythm, such as prescription anti-arrhythmic or pro-arrhythmic drugs, or over-the-counter medications, such as pseudoephedrine-containing cold medicines
7. Using illicit drugs, such as cocaine or amphetamines

Look at point 6, those are your flu medicine. Never knew it will affect your heart rhythm.

Aetiology for Sudden Cardiac Arrest

References:
http://www.asiaone.com/Health/Fitness/Watch+Your+Body/Story/Why+young+hearts+fail.html

Some of the causes that will lead to sudden cardiac arrest.

1. Hypertrophic cardiomyopathy
2. Anomalous coronary arteries
3. Arrhythmogenic right ventricular dysplasia
4. Electrical disorders that cause irregular heartbeats, such as Brugada syndrome and long QT syndrome
5. Myocarditis

Check out today's The Straits Time. One of the causes they mention was Hypertrophic cardiomyopathy. What is this? Click http://www.asiaone.com/Health/Fitness/Watch+Your+Body/Story/Why+young+hearts+fail.html for more information.

An extract from the url:

Hypertrophic cardiomyopathy

"The thickening can occur near arteries which channel blood from the heart to the rest of the body, and this could block the blood supply, said Dr Bernard Kwok, senior consultant of the National Heart Centre's cardiology department.
The thickened heart muscles also interfere with the electrical signals transmitted by the heart, which results in an irregular heartbeat.
Most people with hypertrophic cardiomyopathy would not notice it, but strenuous exercise could exacerbate the condition. The heart could either stop beating or pound so quickly that it can no longer pump out blood. This could lead to acute heart failure and death, if emergency treatment is not given in time."

... ...

"The genetic condition might not appear at birth but the heart muscle could thicken over time, said Dr Kwok."

NS recruit dies after training walk

10 June 2008
Extracted from The Straits Time online
http://www.straitstimes.com/Latest+News/Singapore/STIStory_246352.html
The polytechnic graduate fainted at 8.35am while he was taking part in a 2km walk at the Basic Military Training Centre on the island. He was given immediate medical attention by doctors.

Official News Release at Mindef http://www.mindef.gov.sg/imindef/news_and_events/nr/2008/jun/10jun08_nr.html

A more recent news

Extracted from the straitstimes online
http://www.straitstimes.com/Latest%2BNews/Singapore/STIStory_247079.html

SAF suspends physical training after 2 trainees died

Regular serviceman, Officer Cadet (OCT) Clifton Lam Jia Hao collapsed at about 5.45 pm on Wednesday and was given immediate first aid treatment by a doctor and a senior medic. He was pronounced dead at 7.20pm in the hospital.

THE Singapore Armed Forces (SAF) on Thursday ordered a halt to all physical and endurance training activities for three days following the deaths of two young servicemen in training.
The 'time-out' from Thursday to Saturday will allow SAF to carry out a comprehensive system check and review its physical and endurance training programmes

Official News release at Mindef:
http://www.mindef.gov.sg/imindef/news_and_events/nr/2008/jun/12jun08_nr.html

Police trainee, 18, dies 2 days after collapsing during

16 May 2008
An extract from The Straits Times online
"A GROUP of 120 full-time police national servicemen set out on a 2.4km run early Tuesday morning around the parade square of the Home Team Academy.
But one of them never completed the run and was found lying unconscious in the camp in Old Choa Chu Kang Road.
Mr Roslan Saharo, 18, who was just two months into his basic training, would never wake up again.
After two days in a coma, his family decided yesterday morning to take him off life support. "

http://www.straitstimes.com/Free/Story/STIStory_237826.html

Cardiac SOS

Try to capture some of the cardiac arrest cases, not all are captured. I got nothing against any organisation.
Sudden Cardiac Arrest Time Line
23 September 2003 : Recruit collapse after IPPT Categorisation Test
15 June 2007:DXO died after running treadmill
25 Jun 2007: Triathelet,17, who died of heart failure after completing a race.
26 August 2007:Army regular collapses and dies after half-marathon
29 November 2007:Air Force NSF collapses, dies after run
2 January 2008:SAF officer collapses, dies after 1.2 km run
16 May 2008: Police trainee, 18, dies 2 days after collapsing during run
10 June 2008:NS recruit dies after training walk.
11 June 2008: RSAF serviceman dies after collapsing during training

Sources
http://health.asiaone.com/Health/News/Story/A1Story20070826-23153.html
http://www.asiaone.com/Health/Fitness/Watch%2BYour%2BBody/Story/Why%2Byoung%2Bhearts%2Bfail.html
http://www.asiaone.com/Health/Fitness/Story/A1Story20070630-16729.html
Mindef related news at http://www.mindef.gov.sg/imindef/news_and_events/nr.html