Sudden death after a cold drink: case report

We report a case of sudden cardiac death in a 12-year-old boy after rapid ingestion of a frozen slurry drink. The cause of death was determined to be a cardiac arrhythmia secondary to a previously undiagnosed cardiac rhabdomyoma with associated myocardial scarring. Ingestion of cold liquids has been associated with syncope, but not sudden cardiac death. In this case, bradycardia induced by cold-induced vasovagal reflex may have precipitated the terminal arrhythmia. Ingestion of cold liquids should be considered a potential trigger for fatal cardiac arrhythmias in patients with underlying heart disease.     

Do barriers to candidacy reduce political competition? Evidence from a bachelor’s degree requirement for legislators in Pakistan

In the 2002 election, candidates for Pakistan’s federal legislature had to possess at least a bachelor’s degree. This policy disqualified 60 out of the 207 incumbent legislators from running for election again. Using a difference-in-differences approach with panel data on all electoral constituencies in Pakistan, I find that this ballot access restriction does not affect political competition across all constituencies with disqualified incumbents equally. Stronger political competition is defined as a larger number of candidates contesting election, a smaller vote share and vote margin for the winning candidate, and a less concentrated candidate field, as measured by a Herfindahl–Hirschman index (HHI) of vote shares. Competition declined significantly in constituencies where the disqualified incumbent belonged to a small party and where literacy levels were lower (signifying a smaller pool of substitute candidates). However, political competition increased in areas where the disqualified incumbent was stronger in terms of his winning vote margin.