Education, Advocacy and Action for Prevention of Sudden Cardiac Death in Student Athletes in American Samoa

Zain Jandial — 2025-11-25

Background: Sudden Cardiac Death (SCD) is one of the common causes of death in young athletes, especially during exercise, and it continues to be a challenge. Although the incidence of SCD among the aged is low, this problem has strong emotional and societal implications. Hypertrophic cardiomyopathy, arrhythmogenic cardiomyopathy, and anomalous coronary arteries are all potentially fatal heart diseases that are frequently blamed for these types of tragic events when they are found at autopsy, and might be preventable with early recognition.

Objectives: This review seeks to evaluate where we stand with SCD in the young athlete, determine the aetiology, and suggest guidelines for diminishing its occurrence. This paper underscores the significance of pre-participation screenings, the availability of Automated External Defibrillators (AEDs), and formalised Emergency Action Plans (EAPs) in the mitigation of SCD risks, centring in particular on inadequate resources in areas such as American Samoa.

Methods: A literature review of the past decade was conducted, including the databases PubMed, Scopus, and Google Scholar. The search also included findings related to the prevalence of SCD, risk factors, screening and prevention in youth athletes and public health accounts highlighting systemic inequities in specific locales.

Results: SCD in young athletes occurs with a prevalence of 1 per 300,000 per year. Activities with high athletic risk profiles, like soccer and basketball, are particularly linked with SCD. Undiagnosed heart disease is the main aetiological factor, while ECG screening and AED availability demonstrate a better survival. But there is still inequity, particularly in underserved areas like American Samoa.

Conclusion: Strategies, including widespread screening programs, availability of AEDs, and trained personnel, are required to decrease the prevalence of SCD. A combined approach toward detection and response is required in order to avoid preventable deaths in young sportsmen and sportswomen.

Assessment of Pyrazinamide-Associated Hyperuricemia Among Multidrug-Resistant Tuberculosis Patients Receiving Pyrazinamide-Containing Regimens: A Retrospective Cross-Sectional Study from Sudan

Mayada E. Abdelrahman — 2025-11-26

Background: Tuberculosis (TB) is still one of the most important causes of morbidity and mortality worldwide. The problem multiplies whenever there is multidrug-resistant TB (MDR-TB), due to Mycobacterium tuberculosis susceptibility to both Rifampicin and Isoniazid. Pyrazinamide (PZA) is often added to TB regimens if there is susceptibility; however, one adverse reaction to it is that it causes hyperuricemia. This study was conducted to investigate hyperuricemia induced by PZA among MDR-TB patients attending the Abu Ajja Teaching Hospital in the State of Khartoum, Sudan.

Methods: A retrospective cross-sectional study was carried out among 84 MDR-TB patients who received treatment in the hospital’s MDR-TB ward during 2020-2021. Serum uric acid measurements (pre-PZA baseline values and months 1-5 post-PZA treatment initiation) were obtained by spectrophotometry. The data was analyzed with paired t-test to compare each group to the baseline values. A p-value < 0.05 was taken to be statistically significant.

Results: Among the study population, 67.9% were male, and 48.8% were aged between 18 and 30 years. The majority (89.3%) were Sudanese, and 58.3% were classified as underweight. The mean baseline serum uric acid level prior to PZA therapy was 4.47 ± 1.17 mg/dL. Following the initiation of PZA, a progressive and statistically significant increase in serum uric acid was observed across all subsequent months: 8.67 ± 2.39 mg/dL (p < 0.001) in month 1, 8.94 ± 2.07 mg/dL (p < 0.001) in month 2, 9.04 ± 1.89 mg/dL (p < 0.001) in month 3, and 9.56 ± 1.85 mg/dL (p < 0.001) in month 4. By month 5, the mean serum uric acid level further increased to 9.69 ± 1.96 mg/dL (p < 0.001) compared with baseline values.

Conclusion: In this group of patients with MDR-TB undergoing PZA-containing regimens, there was a statistically significant increase in the levels of uric acid in the blood during the initial five months of treatment. These results highlight the need to take uric acid levels into consideration during TB treatment regimens that include PZA, even in resource-limited centers.

Journal of Advances in Medical and Pharmaceutical Sciences

Education, Advocacy and Action for Prevention of Sudden Cardiac Death in Student Athletes in American Samoa

Assessment of Pyrazinamide-Associated Hyperuricemia Among Multidrug-Resistant Tuberculosis Patients Receiving Pyrazinamide-Containing Regimens: A Retrospective Cross-Sectional Study from Sudan