After the outbreak of the coronavirus disease in late 2019 (COVID-19), an infectious disease caused by a newly discovered coronavirus SARS-CoV-2, the number of confirmed cases worldwide has reached more than 4.2 million, resulting in a death toll of more than 293 thousand (as of May 13, 2020). Common symptoms associated with COVID-19 include fever, cough, loss of appetite, fatigue, short of breath and muscle aches. Loss or disturbances in taste and smell have also been reported in some cases. While most of the focus on COVID-19 has been on its pulmonary complications like pneumonia and acute respiratory distress syndrome (ARDS), emerging evidence suggests that cardiovascular (CV) complications, resulting either from SARS-CoV-2 infection or from adverse effects of pharmacologic therapeutics, could contribute significantly to the mortality associated with COVID-19. This article briefly summarized recent reports on the cardiovascular complications linked to COVID-19 that every cardiologist should be aware of when treating these patients.

Cardiovascular disease (CVD) is the leading cause of death in the world and the second important cause of death in Taiwan. Atherosclerosis CVD (ASCVD) especially coronary artery disease (CAD) is the major cause of CVD [1]. Clinically, the presentation of CAD can be divided into acute unstable disease, so-called acute coronary syndrome (ACS) and chronic stable disease. Up to now, the main risk factors for CAD are known as hyperlipidemia, hypertension, hyperglycemia, smoking and family history. The control of the above risk factors and lifestyle modifications can improve the prognosis of CAD patients [1,2]. Here, we described the blood lipid control, blood pressure control, blood glucose control, and lifestyle modifications for CAD in Taiwan. The followings are the part III for blood glucose control. Type 2 Diabetes mellitus (T2DM) has been suggested a CAD equivalent. The risk of CAD may be correlated with the baseline HbA1c. Numerous studies have demonstrated the benefits of controlling modifiable CV risk factors in people with diabetes. Therefore, in patients with documented CAD, DM control is recommended.Because the benefits of intensive glucose control emerge slowly, while the harms can be immediate, people with longer life expectancy have more to gain from intensive glucose control. The 4 randomized clinical trials (RCTs), including UKPDS, ACCORD, ADVANCE, VADT trials, or large meta-analyses, testing intensive glucose control vs. conventional glucose control did not show positive results in reducing major adverse cardiovascular events (MACE) in individual trials. There are also lack of HbA1c target CV outcome trials in patients with CAD. The impact of glucose control on macrovascular complications is less certain. In the consensus, glycemic treatment targets should be individualized based on patient characteristic, including frailty and comorbid conditions, and risk of adverse effects of therapy (e.g., hypoglycemia and weight gain), to balance the benefit and risks of glycemic control, rather than the strengthen the HbA1c target in patients with documented CAD.

Lipid lowering therapy to reduce LDL-C level is the cornerstone to reduce the cardiovascular disease (CVD) risks, but it should not be one size fits all. Precision medicine is an emerging field that calls for individualization of treatment strategies based on characteristics unique to each patient. Over the past few years, more evidences about new treatments and which patients may benefit from them were uncovered. Therefore, the latest clinical practice guidelines provide recommendations applicable to patients with different CVD risks. Clinicians can now treat their patients individually according to the presence of cardiovascular diseases, traditional risk factors, family history, ethnicity, certain health conditions such as metabolic syndrome, chronic kidney disease, chronic inflammatory conditions, or the coronary calcium score. In addition, several genetic predictors of statin response have already been identified, which might further identify patients who are more likely to benefit from lipid-modifying therapy as opposed to those who likely will suffer from its side effects using precision medicine tools.

Background/Synopsis: The contribution of long-term air pollution exposures to subclinical atherosclerosis in young age has not been fully studied. Objectives/Purpose: This study is to evaluate to assess the associations of carotid intima-media thickness (CIMT) values in adolescents or young adults with one-year exposures to different sizes of particulate matter (PM) and traffic-related exhausts. Methods/Results: We recruited 789 school age subjects who resided in Taipei City and participated in the YOung TAiwanese (YOTA) Cohort between 1992 and 2000. Of all study subjects, 303 subjects were elevated blood pressures (EBP) and 486 subjects had normal BP (NBP) in the childhood. The CIMT values at different segments were measured at the age of 12-30 in the follow-up health examination from 2006 to 2008. Land-use regression models were used to estimate participants' one-year exposures to particulate matter (PM) of different sizes and traffic-related exhausts, including PM2.5 absorbance, nitrogen oxides, and nitrogen dioxides. Generalized linear regression was applied to assess the associations of CIMT values in adolescents or young adults with one-year exposures to six air pollutants. Our findings indicate one-year exposure to PM2.5 absorbance is associated with increased mean and maximum CIMT at different carotid segments. Specifically, exposure to PM2.5 absorbance among subjects who exhibited elevated childhood blood pressure is associated with an increases in mean CMIT at common carotid artery by 3.94% (95%CI: 0.24, 7.64), carotid bulb by 7.77% (95%CI: 2.95, 12.95), and internal carotid artery by 4.75% (95%CI: 0.67, 8.84). Similar increases in the maximum CIMT values were evident at the aforementioned sites. Moreover, older age, gender and health status (overweight, elevated blood pressure, hyperglycemia and hypercholesterolemia), coupled with high level exposure to PM2.5 absorbance (≥2.18 10-5 m-1; 75th percentile), are particularly at risk for developing increased CIMT. Conclusion: Long-term exposure to PM2.5 absorbance is positively associated with subclinical atherosclerosis in adolescents or young adults. The atherosclerosis developed since early childhood depending on individual cardiovascular risk factors including overweight, hypertension, hyperglycemia, or hypercholesterolemia, and can be modified by PM2.5 absorbance concentration.

Background/Synopsis: The prevalence of obesity among older adults is rising progressively. It has been shown that obesity confers an increased risk of mortality to those who have an extreme body mass index. However, there is inadequate published data on the factors associated with obesity among older adults in our community. Objectives/Purpose: To determine the factors associated with obesity among Malaysian aged 60 years and above who voluntarily attended the health screening program from 2011 to 2018. Methods/Results: Method. This cross-sectional study was conducted in both East and West Malaysia incorporating the nine states and regions in Malaysia which involves older adults more than 60 years old (age range 60-102 years; 333 males (46.5%) and 383 (53.5%) females). The study protocol was reviewed and approved by the Local Institutional Ethics Committee. Standardized questionnaires were used to collect the information on sociodemographic, family and medical history. Anthropometric indices, blood pressure, and selected biochemical analysis were also collected. For further analysis, subjects were classified into obese (BMI ≥ 30 kg/m2) and non-obese (BMI ＜ 30 kg/m2). Results. A total of 716 older adults age ≥60 years old (median 65.0 years old with an interquartile range of 8.0 years old) involved in the study. The prevalence of obesity was 16.2% in which higher prevalence was found among females (58.4 %) compared to males (41.6%). Furthermore, females have 1.46 times higher odds of being obese compared to males (95% CI: 0.97-2.18). Eighty-seven percent of the low-income group (Bottom 40%) was significantly associated with obesity (OR: 2.92, 95% CI: 1.39-6.15). Those without diabetes mellitus have 2.12 times higher odds of developing obesity (p=0.001, OR 2.123, 95% CI 1.37, 3.27). No family history of premature coronary artery disease (OR: 2.11, 95% CI: 1.190, 3.742) and hypertension (OR: 1.69, 95% CI: 1.098, 2.59) were also significantly associated with obesity. Conclusion: Females in a low-income group with no family history of some chronic diseases will increase the odds of having obesity. Therefore, preventive health education and promotion should be more directed at this group.

Rape can be occured in all women from all side of life, occupations, age, and marital status, which was done alone or abuzz. The perpetrators of violence also come from various circles, work, age, social class and marital status. In this case, the number of women violence against in Atambua is quite high. Sexual abuse cases and sexual harassment turned out most of the perpetrators are still related to blood with victims, such as biological father, siblings, uncle and neighbors. The cases of sexual assault against women in Atambua are resolved in customary. However, any form of resolution, the act of violence of rape against viewed from various aspects still must be responded as a criminal act, for example the custom settlement of tallitan tafani still apply penal sanction in the form of penalty as one of the effort of restoration of good name, and also dignity for the victim.

The 21st century saw the rapid development of the administration of the nations of the world. With the development, it is essential to ensure that administrator entrusted with the administration of the country perform its duties in accordance with the rule of law. It must not act arbitrarily. Discretionary power if given to the administrator, it is limited. This is to guarantee that administrator in performing its duties would not infringe rights of an individual or community, especially fundamental rights. To make certain that this is achieved, an effective mechanism for the protection of rights, especially human or fundamental rights in state administration is needed. Judicial review is one of the effective mechanism to supervise and control action of the administrator. This mechanism is available in Administrative Law. Under the instrument, grounds of judicial review is made available to review action of the administrator. Currently, there are two streams of judicial review: Administrative Review and Constitutional Review. The former is a non-right based review of administrator’s power founded on the traditional common law using Wednesbury objective test or CCSU grounds not involving violation of fundamental and human right and the procedures. Meanwhile, the latter is a right-based review involving the exercise of administrative powers that violate the constitutional right of an individual or community, particularly, fundamental rights. The traditional common law, nevertheless, are inadequate in addressing review of administrative action involving violation of fundamental rights. For that reasons constitutional review as another stream in judicial review was developed. This was illustrated looking into the development in United Kingdom, India, Malaysia, South Africa and Hong Kong. With the expansion, mentioned the common law countries are capable of providing a more comprehensive and meaningful protection to an individual or community against unlawful act of the administrator that violates rights, especially human and fundamental rights. Consequently, state integrity is strengthen and be more accountable to the community. Hence, state can develop administration that is sound, and efficient in human, natural, economic and financial management. The proper enforcement of human rights will promote political and socio-economic stability, provide legal certainty and it encourages investors to invest in the country.