Thursday, March 09, 2006

The Star misses opportunity to educate the public

The Star carries an article of a young boy (14) who faints and goes into a coma.

IPOH: A Form Two student of SM Sultan Abdul Jalil Shah went into a coma, after complaining of a severe headache just moments before losing consciousness. Doctors at the Ipoh Hospital found blood clots in the brain and a fracture in the skull of 14-year-old Khambali Amat.

His father, Felda settler Amat Basiron, last saw his son last month when the boy left their Felda Changkat Lada home in Kampung Gajah to return to the boarding school in Seberang Perak, Parit. Amat, 61, said he received a call on Saturday morning telling him that his son was unwell.

“I got the call at 7am. When I rushed to the school, my son had already been admitted to Teluk Intan Hospital,” he said. Khambali was transferred the same day to Ipoh Hospital, where doctors found that he had head injuries. “When he left on Feb 27, he was well. I just can’t believe that he is now lying in hospital,” said the teary-eyed father.

Amat said that Khambali, who was the seventh child among nine siblings, was active in sports and had never complained of problems at school. “I was told by the school authorities that my son had complained of a severe headache moments before he fainted,” he said, adding that Khambali was rarely ill. “Now as he lies in bed, I can only whisper in his ear to stay strong and have faith in God.”

State deputy CID chief Supt Hud Abd Rahman said initial investigations showed that the boy had been found frothing at the mouth by a school staff. He added that police did not suspect foul play.

Quite clearly the Star spoke to the father (look for the sentences in quote marks) and the police but there's not a peep from the doctors who treated the boy.

Hopefully all doctors out there can read the symptoms and come up with something. The Star has not helped us in this since clearly the reporter was more interested to speak to the police and get a quote. Interestingly enough while the police suspect no foul play the Star put in police quotes anyway, if this was a medical case with no foul play then where are the medical quotes?

If the reporter wanted to inform the public he should have started by printing whether the boy fainted first prior to this incident. Fainting could potentially have caused a fractured skull. Or was there "assault". Who knows what goes on in these residential schools, but we "suspect no foul play" so that we "step on no feet"? More details of the right kind please.

Let's assume there's no foul play. Then we're in business of looking for cardiac arrhythmia (Ventricular fibrillation), that stopped the heart. This will explain the foaming at the mouth. These cardiac arryhthmia can be familial (e.g. Romano-Ward Syndrome and Jervell-Lang-Neilsen syndrome), and assymptomatic before hand (in Jervell and Lange Neilsen syndrome, you may have congenital deafness) and the first episode is also the last episode. The former syndrome are part of the Long QT syndrome.

The other familial arrhythmia syndrome common in Asia, and Spain is Brugada syndrome. Remember about 2 or 3 years ago, there were reports of young Thais dying suddenly. Many of them were discovered dead in Singapore, with no suspicion of foul play? We suspect that they were the Asain variant of the Brugada syndrome.

However, re-reading the Star article it does mention that the boy complained of haedaches, then fainted, and was found with a fractured skull and also blood clot in the brain. The answer? Possibly he had a "berry aneurysm" in the brain that burst, resulting in the headache and blood clots in the brain.

In any case a responsible and informed press would have asked the family to go in for screening since all these conditions are familial in nature. Familial arrhythmias would probably mean there is brother waiting for this to happen.

As for an anuerysm we should also screen the family. Int his case there is a small association with long hands and feet, and increased flexibilty of his fingers . Associated hypertension may also be a factor.

Certainly, the police must exclude foul play but since they have already ruled out foul play it's time the press was more responsible in educating the public, starting with this already bereaved family, than in publishing sensational copy to sell more newspapers.

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