February 23, 2018, 10:18 pm
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1 Philippine Peso = 0.07045 UAE Dirham
1 Philippine Peso = 2.04297 Albanian Lek
1 Philippine Peso = 0.03415 Neth Antilles Guilder
1 Philippine Peso = 0.38059 Argentine Peso
1 Philippine Peso = 0.02443 Australian Dollar
1 Philippine Peso = 0.03415 Aruba Florin
1 Philippine Peso = 0.03837 Barbados Dollar
1 Philippine Peso = 1.59409 Bangladesh Taka
1 Philippine Peso = 0.0304 Bulgarian Lev
1 Philippine Peso = 0.00723 Bahraini Dinar
1 Philippine Peso = 33.58872 Burundi Franc
1 Philippine Peso = 0.01918 Bermuda Dollar
1 Philippine Peso = 0.02533 Brunei Dollar
1 Philippine Peso = 0.13159 Bolivian Boliviano
1 Philippine Peso = 0.06235 Brazilian Real
1 Philippine Peso = 0.01918 Bahamian Dollar
1 Philippine Peso = 1.2325 Bhutan Ngultrum
1 Philippine Peso = 0.18295 Botswana Pula
1 Philippine Peso = 384.03989 Belarus Ruble
1 Philippine Peso = 0.03832 Belize Dollar
1 Philippine Peso = 0.02429 Canadian Dollar
1 Philippine Peso = 0.018 Swiss Franc
1 Philippine Peso = 11.42605 Chilean Peso
1 Philippine Peso = 0.12152 Chinese Yuan
1 Philippine Peso = 54.88202 Colombian Peso
1 Philippine Peso = 10.87186 Costa Rica Colon
1 Philippine Peso = 0.01918 Cuban Peso
1 Philippine Peso = 1.71801 Cape Verde Escudo
1 Philippine Peso = 0.39493 Czech Koruna
1 Philippine Peso = 3.3921 Djibouti Franc
1 Philippine Peso = 0.11601 Danish Krone
1 Philippine Peso = 0.94226 Dominican Peso
1 Philippine Peso = 2.17652 Algerian Dinar
1 Philippine Peso = 0.24369 Estonian Kroon
1 Philippine Peso = 0.33858 Egyptian Pound
1 Philippine Peso = 0.52177 Ethiopian Birr
1 Philippine Peso = 0.01557 Euro
1 Philippine Peso = 0.03825 Fiji Dollar
1 Philippine Peso = 0.01371 Falkland Islands Pound
1 Philippine Peso = 0.01377 British Pound
1 Philippine Peso = 0.08533 Ghanaian Cedi
1 Philippine Peso = 0.89967 Gambian Dalasi
1 Philippine Peso = 172.74122 Guinea Franc
1 Philippine Peso = 0.14073 Guatemala Quetzal
1 Philippine Peso = 3.9296 Guyana Dollar
1 Philippine Peso = 0.15011 Hong Kong Dollar
1 Philippine Peso = 0.45024 Honduras Lempira
1 Philippine Peso = 0.11584 Croatian Kuna
1 Philippine Peso = 1.216 Haiti Gourde
1 Philippine Peso = 4.85824 Hungarian Forint
1 Philippine Peso = 261.23153 Indonesian Rupiah
1 Philippine Peso = 0.06714 Israeli Shekel
1 Philippine Peso = 1.24329 Indian Rupee
1 Philippine Peso = 22.71245 Iraqi Dinar
1 Philippine Peso = 713.12103 Iran Rial
1 Philippine Peso = 1.9248 Iceland Krona
1 Philippine Peso = 2.40936 Jamaican Dollar
1 Philippine Peso = 0.01359 Jordanian Dinar
1 Philippine Peso = 2.0619 Japanese Yen
1 Philippine Peso = 1.9413 Kenyan Shilling
1 Philippine Peso = 1.3061 Kyrgyzstan Som
1 Philippine Peso = 77.09572 Cambodia Riel
1 Philippine Peso = 7.62709 Comoros Franc
1 Philippine Peso = 17.26453 North Korean Won
1 Philippine Peso = 20.55496 Korean Won
1 Philippine Peso = 0.00575 Kuwaiti Dinar
1 Philippine Peso = 0.01573 Cayman Islands Dollar
1 Philippine Peso = 6.12565 Kazakhstan Tenge
1 Philippine Peso = 158.52676 Lao Kip
1 Philippine Peso = 28.96605 Lebanese Pound
1 Philippine Peso = 2.97621 Sri Lanka Rupee
1 Philippine Peso = 2.45904 Liberian Dollar
1 Philippine Peso = 0.22463 Lesotho Loti
1 Philippine Peso = 0.05848 Lithuanian Lita
1 Philippine Peso = 0.0119 Latvian Lat
1 Philippine Peso = 0.02544 Libyan Dinar
1 Philippine Peso = 0.17647 Moroccan Dirham
1 Philippine Peso = 0.31853 Moldovan Leu
1 Philippine Peso = 0.95396 Macedonian Denar
1 Philippine Peso = 25.47477 Myanmar Kyat
1 Philippine Peso = 45.90946 Mongolian Tugrik
1 Philippine Peso = 0.15451 Macau Pataca
1 Philippine Peso = 6.71398 Mauritania Ougulya
1 Philippine Peso = 0.62536 Mauritius Rupee
1 Philippine Peso = 0.29868 Maldives Rufiyaa
1 Philippine Peso = 13.76098 Malawi Kwacha
1 Philippine Peso = 0.35911 Mexican Peso
1 Philippine Peso = 0.07494 Malaysian Ringgit
1 Philippine Peso = 0.22327 Namibian Dollar
1 Philippine Peso = 6.88663 Nigerian Naira
1 Philippine Peso = 0.59477 Nicaragua Cordoba
1 Philippine Peso = 0.15035 Norwegian Krone
1 Philippine Peso = 1.98703 Nepalese Rupee
1 Philippine Peso = 0.02611 New Zealand Dollar
1 Philippine Peso = 0.00738 Omani Rial
1 Philippine Peso = 0.01918 Panama Balboa
1 Philippine Peso = 0.06229 Peruvian Nuevo Sol
1 Philippine Peso = 0.0629 Papua New Guinea Kina
1 Philippine Peso = 1 Philippine Peso
1 Philippine Peso = 2.11989 Pakistani Rupee
1 Philippine Peso = 0.06472 Polish Zloty
1 Philippine Peso = 106.82716 Paraguayan Guarani
1 Philippine Peso = 0.06982 Qatar Rial
1 Philippine Peso = 0.07256 Romanian New Leu
1 Philippine Peso = 1.0862 Russian Rouble
1 Philippine Peso = 16.12737 Rwanda Franc
1 Philippine Peso = 0.07193 Saudi Arabian Riyal
1 Philippine Peso = 0.14866 Solomon Islands Dollar
1 Philippine Peso = 0.2582 Seychelles Rupee
1 Philippine Peso = 0.34501 Sudanese Pound
1 Philippine Peso = 0.15536 Swedish Krona
1 Philippine Peso = 0.02534 Singapore Dollar
1 Philippine Peso = 0.01372 St Helena Pound
1 Philippine Peso = 0.42597 Slovak Koruna
1 Philippine Peso = 146.36485 Sierra Leone Leone
1 Philippine Peso = 10.78074 Somali Shilling
1 Philippine Peso = 381.75523 Sao Tome Dobra
1 Philippine Peso = 0.16785 El Salvador Colon
1 Philippine Peso = 9.87876 Syrian Pound
1 Philippine Peso = 0.22325 Swaziland Lilageni
1 Philippine Peso = 0.60368 Thai Baht
1 Philippine Peso = 0.04586 Tunisian Dinar
1 Philippine Peso = 0.0428 Tongan paʻanga
1 Philippine Peso = 0.07262 Turkish Lira
1 Philippine Peso = 0.12717 Trinidad Tobago Dollar
1 Philippine Peso = 0.55966 Taiwan Dollar
1 Philippine Peso = 43.06541 Tanzanian Shilling
1 Philippine Peso = 0.51746 Ukraine Hryvnia
1 Philippine Peso = 69.67197 Ugandan Shilling
1 Philippine Peso = 0.01918 United States Dollar
1 Philippine Peso = 0.54556 Uruguayan New Peso
1 Philippine Peso = 156.62766 Uzbekistan Sum
1 Philippine Peso = 478.3426 Venezuelan Bolivar
1 Philippine Peso = 435.71839 Vietnam Dong
1 Philippine Peso = 1.98465 Vanuatu Vatu
1 Philippine Peso = 0.04817 Samoa Tala
1 Philippine Peso = 10.20986 CFA Franc (BEAC)
1 Philippine Peso = 0.05179 East Caribbean Dollar
1 Philippine Peso = 10.20986 CFA Franc (BCEAO)
1 Philippine Peso = 1.85248 Pacific Franc
1 Philippine Peso = 4.79474 Yemen Riyal
1 Philippine Peso = 0.22325 South African Rand
1 Philippine Peso = 99.5492 Zambian Kwacha
1 Philippine Peso = 6.94226 Zimbabwe dollar

Sudden cardiac death

SUDDEN Cardiac Death (SCD) is a swift and unexpected death caused by a heart condition or mechanism, which may or may not be obvious. SCD varies in its range of definition. Usually, though, it applies to a situation where the person, who was thought to be free of heart disease, or only had a “mild” heart disease, suddenly died.

What causes these sudden deaths?

In the age range between 40 and older, the vast majority is due to coronary artery disease (heart “attacks”). In 20% (one out of five) of those who develop symptoms of coronary artery disease, and even among those with advanced coronary artery disease, the first symptom of the disease is sudden death. In those younger than forty years old, including teenagers, sudden death from “no apparent reason” is usually due to fatal ventricular arrythmia (heart irregularity), which could be brought on by electrolyte imbalance and other factors, and in some cases, to totally unknown cause. Brugada Syndrome is one such demise from a fatal heart rhythm abnormality.

Can illegal drugs cause sudden death?

Yes. Other “recreational” drugs could also lead to sudden death, many by causing deadly heart irregularity. Among some individuals, cigarette smoking could cause heart rhythm problems that lead to cardiac arrest. Thank God, this is rare.

What is a “Widow-Maker” heart disease?

As the name implies, this particular condition results in sudden deaths among men, leaving their wives widows. This is usually due to a severe blockage of the left main coronary artery. If the left main coronary artery is blocked, all the left ventricular muscles are deprived of blood causing a massive acute heart attack, followed by sudden death. Even a single coronary blockage, if severe enough, could be dangerous, and deadly, depending on the portion of the heart that suffers.

Could Mitral Valve Prolapse cause sudden death?

Yes, but, fortunately, very rarely. Mitral Valve Prolapse is a condition where this valve on the left side of the heart (between the left upper and left lower chamber) is kind of “limp” and “weak” resulting in a slightly or moderately leaking Mitral Valve. This condition is generally benign and does not require surgery in majority of cases. Medications and some lifestyle changes are the therapies of choice.

What are the usual symptoms prior to SCD?

Interviews with family of the victims usually reveal some angina (chest discomfort or tightness), or heart irregularity, and/or shortness of breath, and worsening of the symptoms over a few days or a few hours before sudden collapse and death in 75% of these people. Some of these symptoms may even be confused with indigestion, fatigue, muscle pains, or depression. Self-denial (of symptoms) makes this condition treacherous. Anyone with any of these symptoms should consult their physicians without delay. In many cases, the first symptoms is cardiac arrest.

Does a normal EKG preclude SCD?

No, a plain resting EKG that is reported as normal does not eliminate the possibility of Sudden Cardiac Death, especially among patients with coronary artery disease, whether previously diagnosed or still undetected. This is why a Stress EKG, preferably with Thallium, or Stress Echocardiography, is recommended to find out how the heart would behave under stress. These are more accurate and significant tests compared to a simple resting EKG. A plain EKG is only helpful if it shows abnormal findings. If it is “normal,” it does not have an accurate diagnostic value, and thus, cannot be depended upon for prognostication.

What is Brugada Syndrome?

Brugada Syndrome is a baffling condition where a young person, who appears to be healthy, unexpectedly develops cardiac arrest, for no apparent reason. Most victims do not survive the episode. This condition is now believed to be responsible for countless sudden deaths among young people - athletes, students, etc., - who suddenly dropped dead.

Did the victims have any prior symptoms?

No, majority of victims did not have any prior symptoms. They were “in good health” when suddenly they collapsed, went into coma, and later died, or died on the spot. Three Doctors Brugada (R, P & J) and their colleagues at the Unitat d’Aritmies, Hospital Clinic, in Barcelona, Spain, were the first to describe the syndrome in November 1992. The characteristic EKG findings in this syndrome was first described in 1980 among six patients who had cardiac arrest and were successfully resuscitated. It was not recognized at that time as a disease entity, but those were classic victims of Brugada Syndrome.

How does one prevent Brugada Syndrome?

Since this disease entity has now been “described,” which makes diagnosis of this entity possible, everyone, especially those with a family history of unexplained sudden cardiac arrest, should be tested, starting with an EKG, and some “provocative” tests (with disopyramide, flecainide, ajmaline, procainamide) done to reproduce the characteristic Brugada EKG findings. 

Can genetic testing help?

Since this disease is secondary to a mutation of SCN5A gene of chromosome 3 that has a dominant autosomic transmission pattern, with genetic defect in the alpha subunit of the sodium channel, genetic testing may be in order. However, 30% to 80% of patients will have negative (normal) gene screening in spite of overt or latent clinical Brugada Syndrome. 

What’s the treatment for Brugada Syndrome?

If one is diagnosed to have Brugada Syndrome, an automatic implantable cardiac-pacemaker defibrillator (AICD) may be implanted, which will pace the heart and increase the rate if the rate goes down (awake or when asleep, 24/7), and shocks and jolts the heart back to normal rhythm, when the heart goes to ventricular fibrillation. Hundreds of thousands of people worldwide have AICD to prevent sudden death from a variety of causes. None of the available drugs today are effective against Brugada Syndrome. When diagnosis is made, which may be missed a lot of time, then cardiac arrest may be prevented with AICD.

Can other sudden cardiac deaths be prevented?

Since most of these SCDs are due to coronary artery disease, primary prevention should be aimed at warding off coronary artery disease before it develops, like avoidance of cigarette smoking, obesity, sedentary lifestyle; and the management of high blood pressure, diabetes, and elevated cholesterol, if these are present. Secondary prevention is by early diagnosis and treatment of coronary artery disease, and any medically significant heart irregularity present. Where indicated, coronary angioplasty or bypass may be done. AICD implantation should be considered for those with a history of recurrent cardiac arrests.

***

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