The Obsessive-Compulsive Inventory-Revised (OCI-R) is a valid and reliable instrument used to screen obsessive-compulsive disorder (OCD) symptoms. This scale has been translated into numerous languages, although not the Malay language. The aim of this study is to examine the reliability and validity of Malay-language OCI-R in a community population. The 18-item surveys were completed by 223 healthy people. The OCI-R English version was translated backward and forward to the Malay language. Prior to distributing the questionnaire to the participants, face validity was done. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were run to determine the psychometric qualities of the Malay language OCI-R. A total of 223 respondents mean aged of 33 (6.9) years, and 62% of respondents were female participated in this study. Based on EFA, the Malay language OCI-R showed high internal consistency and good convergent validity with a five-factor domain: "Washing", "Ordering", "Obsessions", "Checking" and "Hoarding". CFA analysis indicated an adequate fit index of (ꭓ2(160) = 4.24, root mean square error of approximation = 0.09, goodness of fit index = 0.89, adjusted goodness of fit index = 0.82, normed fit index = 0.91 and comparative fit index = 0.93) which supported a five-factor domain structure. The Malay OCI-R had a strong internal consistency, making it a credible and valid tool for identifying OCD symptoms in the general public. To improve the generalisability of these results, a larger study should be carried out with a bigger sample size and involving psychiatric patients.
The current COVID-19 pandemic has prompted the development of vaccines to control the spread and severity of SARS-CoV-2. However, there are growing reports of different types of strokes, including ischemic and hemorrhagic strokes, as well as cerebral venous sinus thrombosis (CVST), following COVID-19 vaccination. We presented a case involving a 55-year-old male with a history of ischemic heart disease who exhibited an atypical presentation of visual field impairment one week following Sinovac-CoronaVac COVID-19 vaccination. The patient also experienced mild headache and vomiting for two days preceding the onset of visual symptoms. Right eye's best-corrected visual acuity was 6/24, and left 6/15. A visual field confrontation test indicated left homonymous hemianopia. An urgent CT venography of the brain documented right transverse sinus thrombosis with occipital haemorrhagic infarct. A nasopharyngeal swab tested negative for SARS-CoV-2, and baseline blood investigations were within normal ranges. The patient was given one week of low-molecular-weight heparin, followed by a three-month course of oral anticoagulant. Post-treatment, there was marginal improvement, although a residual visual field defect persisted. In conclusion, while COVID-19 vaccination remains essential, clinicians must remain vigilant for rare adverse events like CVST and be prepared to manage these cases promptly to ensure patient safety.
Superior mesenteric artery syndrome (SMAS), or Wilkie's syndrome, is a rare cause of duodenal obstruction, whereby the duodenum is compressed between the superior mesenteric artery (SMA) and abdominal aorta (AA) due to a loss of mesenteric fat pad. This condition is associated with high morbidity and mortality, particularly if the diagnosis is delayed, leading to complications such as gastric perforation or aspiration pneumonia. A 14-year-old boy with an underlying severe autism spectrum disorder, complained of a two-day history of abdominal pain and vomiting, suggestive of gastric outlet obstruction, leading to hyperlactatemia and metabolic acidosis. An immediate contrast-enhanced computerised tomography revealed a significant dilatation of the lower esophagus until the D3 segment of the duodenum, narrowing of the aortomesenteric angle, and shortening of the aortomesenteric distance, findings suggestively of duodenal obstruction secondary to SMAS. However, patient subsequently developed persistent vomiting leading to aspiration pneumonia. He rapidly deteriorated into septic shock with multiorgan failure, ultimately leading to his death. This case report aimed to highlight the challenges in diagnosing and managing SMAS particularly in autistic children as they may have difficulty communicating their distress, and there is a potential of rapid deterioration that requires prompt escalation of care.
Breastfeeding problems are among the most significant barriers to sustaining exclusive breastfeeding. Many postpartum mothers report difficulties in managing breastfeeding challenges due to inexperience, lack of education, or inadequate support. Therefore, addressing breastfeeding-related problems is critical to improving breastfeeding success. This study aimed to assess the level of knowledge and attitudes toward managing breastfeeding problems among postnatal mothers. A cross-sectional study was conducted with 258 postnatal mothers using purposive sampling at Hospital Canselor Tuanku Muhriz between May and June 2024. Data were collected using the Knowledge of Breastfeeding Problems Questionnaire (K-BFQ) and an open-ended question to assess attitudes toward managing breastfeeding problems. Among the 258 respondents, 82.6% had received breastfeeding education, while 17.4% had not. Despite the high rate of education exposure, only 51.2% demonstrated an adequate level of knowledge. In contrast, 96.9% expressed a positive attitude, indicating a willingness to continue breastfeeding even when facing challenges. While this positive attitude is encouraging, it must be supported by sufficient knowledge to ensure mothers can manage breastfeeding effectively and comfortably. These findings highlight the need to strengthen antenatal education, particularly on managing breastfeeding difficulties. Integrating targeted content into antenatal classes may help to improve maternal confidence, knowledge and overall breastfeeding outcomes.
This study aims to investigate and compare the relationship between intracranial pressure (ICP), intraocular pressure (IOP) and translaminar pressure difference (TLPD) in high-tension glaucoma (HTG) patients and healthy individuals. Newly diagnosed HTG patients and healthy subjects without ocular comorbiditieswere recruited. All participants underwent blood pressure, heart rate, body weight, height and comprehensive ocular examinations, including best-corrected visual acuity, IOP measurement, optic nerve head assessment, peripapillary retinal nerve fibre layer and macular imaging, visual field testing, axial length and central corneal thickness measurements. ICP was estimated using the formula: Cerebrospinal fluid pressure (mmHg) = (0.44 x Body Mass Index (kg/m(2))) + (0.16 x Diastolic Blood Pressure (mmHg))-(0.18 x Age (years))-1.91. TLPD was calculated by subtracting the estimated ICP from the IOP. Compared to healthy subjects, HTG patients had significantly higher median IOP [26.00 (24.00-34.00) mmHg vs. 13.00 (10.00-14.00) mmHg], lower median ICP [8.19 (6.86-10.28) mmHg vs. 11.31 (8.91-12.36) mmHg], and higher median TLPD [18.64 (15.27-26.19) mmHg vs. 1.72 (0.27-4.62) mmHg]. There was no correlation between IOP and ICP; however, IOP was significantly correlated with TLPD in both groups, HTG (r = 0.911, p < 0.001) and non-glaucomatous (r = 0.758, p < 0.001). In healthy subjects, TLPD was moderately and negatively correlated with ICP (r =-0.525, p = 0.012). The lower ICP observed in HTG patients suggests that ICP may be associated with the development of glaucoma. Further research is needed to explore the impact of ICP on glaucoma progression and disease management.
Thalassaemia is a prevalent genetic disease in Malaysia affecting up to 6% of the population. A rise in haemoglobin A2 (HbA2) of more than 4% is among the most important parameters for identification of (3-thalassaemia carriers. However, some cases with the HbA2 levels in the borderline range between 3.0% to 3.9% has been shown to harbour alpha-, (3-globin and/or Kr & uuml;ppel-like factor 1 (KLF1) gene abnormalities too. Here, we reported the results of molecular investigations on a group of subjects with borderline HbA2. A total of 45 subjects with borderline HbA2 levels in Hospital Canselor Tuanku Muhriz (HCTM) were identified from the hospital information system. Data of their full blood count using Sysmex XN-1000, and haemoglobin quantitation using Sebia Capillary Variant II were collected. Their DNA were investigated for the presence of locally common pathological mutations in the (3-globin gene, deletions of the alpha-globin gene as well as screened for KLF1 gene mutation. This study found that 44% of the cases with borderline HbA2 in HCTM showed genetic abnormality at the molecular level comprising of (3-globin gene mutation (29%), alpha-gene defect (9%), KLF1 gene abnormalities (4%) and coinheritance of alpha- and (3-gene defect (2%). On the basis of our findings, we strongly suggest molecular methods consisting of (3-and alpha-globin genes study to be considered in the investigation for haemoglobinopathies in the borderline HbA2 group of patients. Further study on KLF1 gene mutation test in our population is recommended to further characterise the common mutations of the gene.
A sharp increase in the prevalence of smoking among adolescents is a significant public health concern. This study is among the first in the literature to explore the mediating effect of perceptions of smoking-related risks on the relationships between smoking and educational and awareness factors among adolescents. Data from the Global Youth Tobacco Survey Timor-Leste were analysed. Probit regression models were utilised to evaluate the impacts of demographic, educational and awareness factors on the likelihood of smoking. The mediating role of smoking risk perception was examined using structural equation modeling. Contrary to common findings, the perception of smoking-related risks was positively linked to the likelihood of smoking. Adolescents who were aware of tobacco control messages in mass media, received education on the risks of smoking and engaged in family discussions about tobacco use had higher perception of smoking-related risks than others, which in turn could impact adolescents' smoking behaviour. However, the relationships between smoking and exposure to graphic or text warnings on cigarette packs, as well as reading school texts that included topics about smoking were not influenced by smoking-related perceptions. In summary, the perception of smoking-related risks mediates the associations between smoking and particular educational and awareness factors among adolescents.
An effective primary childhood vaccination programme ensures high vaccine coverage, with vaccinations administered within the recommended timeframe. However, there is a lack of information on the timeliness of these vaccinations. This study aimed to assess the completeness and timeliness of primary childhood vaccinations in Malaysia. Data from a nationwide cross-sectional survey were analysed. Complete vaccination refers to children who received all primary vaccines regardless of the recommended timeframe. Timely vaccination is defined as vaccines administered within the recommended timeframe, while delayed vaccination refers to those given after this period. Immunisation records were verified by trained nurses. A total of 3,523 children aged 12 to 23 months participated in this survey. The prevalence of overall vaccination coverage was 87.1% (95% CI: 84.9, 89.1). Within this cohort, the prevalence of timely vaccination was 51.2% (95% CI: 47.2, 55.2), while the prevalence of delayed vaccination was 35.6% (95% CI: 31.7, 39.7). The prevalence of delayed vaccination particularly evident in the second dose of pneumococcal and measles-mumps-rubella vaccines at 15.0% (95% CI: 12.8, 17.5) and 11.2% (95% CI: 8.1, 15.3), respectively. Urban-rural disparities were evident, with urban areas demonstrating higher delayed vaccination prevalence (39.0%) than rural areas (27.6%). Johor, Selangor, and Kuala Lumpur & Putrajaya had the highest overall delayed vaccination prevalence (45.5%, 43.0%, and 42.5%, respectively). Malaysia demonstrates commendable overall vaccination coverage at 87.1%; however, the timeliness of vaccination remains a concern, with only 51.2% of children receiving vaccinations within the recommended timeframe. Significant disparities exist between urban and rural areas as well as among states in delayed vaccination rates, likely attributed to the presence of urban poor populations who are less exposed to the importance of vaccination and higher levels of vaccine hesitancy among urban parents. This highlights the need for public health interventions to focus on children in urban areas to improve timely vaccination rates and maximise the effectiveness of immunisation programs.
External hemipelvectomy (EH) involves the surgical removal of an entire lower extremity and ipsilateral pelvis, often resulting in adverse effects on quality of life. Although limb-salvage surgery and internal hemipelvectomy are preferred for preserving function, EH remains a viable option in specific cases. This retrospective case review examines four patients who underwent EH for complex tumour cases, highlighting a paradoxical outcome in surgical decision-making. This review analysed three patients with pelvic bone sarcomas experiencing local recurrence and infections after limb-salvage surgery, leading to chronic depression and adjustment disorders and one with a benign aggressive tumour where limb-salvage surgery was insufficient for complete tumour removal. We assessed clinical courses, complications and postoperative outcomes through medical records, using the European Organisation for Research and Treatment of Cancer Core Quality-of-Life Questionnaire (EORTC QLQ-C30) for QOL and the Musculoskeletal Tumor Society (MSTS) scoring system for functional outcomes. Despite the initial hesitance and apprehension, all patients reported notable enhancements in quality-of-life post-surgery, despite low functional scores due to the absence of a lower extremity. Improvements were particularly evident in social and emotional well-being demonstrating that, although mobility was compromised, the surgical intervention alleviated chronic pain and distress. This review highlights the importance of reconsidering EH in selected cases where limb-salvage surgery is limited, emphasising that even in the face of significant functional loss, the potential for improved quality-of-life can justify the decision for EH.
Floods in Malaysia affect 22% of the population and 29,800 km2 of land. Disaster medicine is vital for flood response and directly involves emergency healthcare workers. Preparedness plans should involve both emergency medicine residents and administrative staffs. This study evaluated emergency healthcare workers' knowledge, attitude and practice (KAP) regarding flood disaster preparedness in Malaysia. This observational cross-sectional study, conducted from January to December 2023, used the validated FloodDMQ-BM 2.0 questionnaire to assess the preparedness of emergency healthcare workers in 25 tertiary government hospitals. The target group were consenting emergency healthcare workers. Of the 496 participants, 434 were included. The sample was nearly balanced (50.5% male, 49.5% female). Most participants had poor knowledge (73%), moderate attitude (63.1%) and poor practice (66.6%) regarding flood preparedness. Multivariate analysis revealed that knowledge was influenced by age and residing state; attitude by age; and practice by gender, experience and involvement in drills. Positive correlations were found between KAP levels. Emergency healthcare workers in Malaysia show inadequate preparedness for flood disasters, with poor knowledge, moderate attitude and poor practice. Factors influencing preparedness include age, gender, residing state and experience. Tailored training is needed to improve healthcare workers' response capabilities during floods.
Plateletpharesis donation could be done more frequently than whole blood donation. This study is designed to explore the correlation between frequency, inter-donation intervals and effects of longterm plateletpheresis donation with the platelet count and immature platelet fraction (IPF). Outcomes from this study will strengthen the safety data for plateletpheresis donation. A total of 244 donors were studied. They were grouped into plateletpheresis (n=184) or whole blood donors (n=60). Participants blood samples were collected and analysed for full blood count and IPF by Sysmex XE-5000. Baseline platelet counts were retrieved from records before the first donation and compared to the most recent pre-donation counts for all the plateletpheresis donors. Finally, the influence of frequency, interval and total duration of plateletpheresis donation on the platelet count and IPF were assessed. Statistically significant reduction of platelet count (273 x 109/L, 172-443) were observed when compared with the baseline pre-donation count (291 x 109/L, 164-478) for plateletpheresis donors. However, this fall is not of clinical significance ad platelet counts were still within normal ranges. Similar observation was made regardless of inter-donation interval and total duration of donation. IPF for the plateletpheresis donors (1.5%, 0.5-7.5) were also comparable with the whole blood donors (1.5%, 0.6-4.8; p=0.848). Frequent plateletpheresis donation with at least 14 days inter-donation intervals and up to 24 donations a year does not cause thrombocytopenia or increase in the IPF. This knowledge is hoped to encourage more people to become donors thus helping blood transfusion services to meet the increasing demand for plateletpheresis product.
Diabetes medication therapy adherence clinics (DMTAC) in Malaysia are crucial for managing type 2 diabetes but encounter significant operational challenges, including high rates of patient non-attendance, program dropout and variability in service delivery, which collectively undermine their effectiveness. Guided by the first three phases of the Double Diamond design-thinking model (discover, define, develop), this study aimed to create an evidence-based pre-delivery framework to systematically address these gaps. Evidence was triangulated from (i) a retrospective cohort study of 198 patients that quantified clinical outcomes and attrition risk factors; (ii) semi-structured interviews with 32 patients that illuminated barriers, facilitators and service preferences; and (iii) a comprehensive scoping review of 61 randomised controlled trials on pharmacist-led diabetes interventions. Design requirements extracted from these sources were mapped to the Transtheoretical Model (TTM), Health Action Process Approach (HAPA) and the communication models of Motivational Interviewing (MI) and Shared Decision-Making (SDM). The resulting framework comprised three sequential domains: (i) Pre-Service: stage-matched assessment of patient readiness and barrier screening; (iii) Within-Service: modular, patient-centred interventions delivered via MI or SDM with explicit action-and coping-planning rooted in HAPA; and (iii) Post-Service: flexible follow-up modalities, tailored self-management aids and automated appointment reminders. This pre-delivery framework offers clinicians and service managers an actionable, theory-informed guide to enhance engagement, medication adherence and clinical outcomes across Malaysian DMTAC settings.
Bartonella henselae is a gram-negative rod bacterium that causes cat scratch disease (CSD) in humans, with the most common manifestation being Parinaud's oculoglandular syndrome. A 37-year-old healthy man with an unremarkable ocular history presented with an acute painless scotoma over the superonasal visual field of the right eye (RE) for 1 week following a cat scratch two weeks before presentation. His visual acuity was 6/12 over the RE and 6/9 over the left eye (LE), with a normal anterior segment examination bilaterally. Fundus examination showed a retinitis patch occluding the right inferotemporal branch with a surrounding pale retina and isolated retinitis was seen superior to the left macula. Fundus fluorescein angiography of RE showed a non-filling defect along the inferotemporal artery branch with the absence of flow distal to the filling defect which signified an occlusion area. Parafoveal vasculitis changes were seen over the LE. Intraretinal fluid over the right macula was detected on optical coherence tomography. Laboratory testing revealed positive Bartonella henselae IgM with IgG titers greater than 1:512. The patient received oral azithromycin for 6 weeks and demonstrated good clinical response. Branch retinal artery occlusion is an uncommon presentation of CSD. Early diagnosis and prompt intervention are essential to restore visual function and prevent further complications.
Locally designed and validated quality of life (QOL) assessments which incorporate psychological-spiritual elements, while also considering the cultural and contextual diversity of Malaysian society, are scarce. This study aimed to develop and assess the psychometric properties of a culturally-relevant Malay psychological QOL questionnaire tailored to the Malaysian context. This study also aimed to explore differences between healthy adults and psychiatric patients in terms of perception of psychological QOL. This study involved process of assessing content validity of the questionnaire item, a pilot study and conducting a field study with two different samples, namely healthy adults psychiatric patients. The analysis has focused on assessing internal consistency and construct validity through Exploratory Factor Analysis (EFA). A total of 120 healthy adults (mean age = 34.5, SD = 6.3) and 120 psychiatric patients (mean age = 34.5, SD = 13.3) participated in this study. Internal consistencies for both healthy adults (Cronbach's alpha= 0.91) and psychiatric patients (Cronbach's alpha = 0.93) were excellent. For both samples, EFA analysis revealed five domains: vigour, emotional resilience, depression and anxiety, religiosity and values and social support, with minimum factor loadings ranged from 0.411 to 0.872. Item loadings for vigour and emotional resilience varied slightly for both groups. This newly designed Psychological Quality of Life (PsychQOL) questionnaire is a multidimensional factor structure with strong psychometric properties, which is suitable for both healthy and psychiatric patients. The PsychQOL offers a culturally and linguistically appropriate alternative for evaluating psychological well-being among Malaysians, particularly the Malay-speaking population. This assessment may serve as a monitoring tool while also offering insights into successful treatment approaches.
Challenging behaviours in children and adolescents with intellectual disability imposes a great challenge in the care-giving process. Family burden is high but it is not commonly focused on the management. Hence, this cross-sectional study aimed to assess challenging behaviours among the intellectually disabled children and adolescents, family burden and its associated factors among their caregivers. A convenient sample of 88 caregivers of children and adolescents attending the Child and Adolescent Psychiatry Unit, Hospital Canselor Tuanku Muhriz participated in the study. Socio-demographic factors and challenging behaviours of the children and adolescents were assessed using a socio-demographic questionnaire and Developmental Behaviour Checklist respectively. Family burden was assessed using Burden of Family Interview Schedule. A total of 52% of the children and adolescents were reported to have challenging behaviours while family burden was reported in 76% of the caregivers. Mean total score of family burden was significantly higher in children and adolescents with challenging behaviours compared to those without challenging behaviours (19.02 vs 4.93, p < 0.001). Self-absorbed behaviours (B: 0.313, 95% CI: 0.222-0.404), duration of contact hours (B: 0.197, 95% CI: 0.074-0.320) and prescription of psychotropic medications (B: 6.474, 95% CI: 1.400-11.548) were significant predictors of family burden in our sample. Family burden is high among caregivers of intellectually disabled children and adolescents, with significantly higher levels of burden reported in the presence of challenging behaviours. Hence, family burden should always be considered in the comprehensive assessment and management of children and adolescents with intellectual disability.
Maternal health information-seeking behaviour (MHSB) refers to the active efforts of pregnant women to obtain specific information to ensure continuity of care, enhance resilience against health risks and prevent complications. Advances in digital health (DH) and the increasing use of social media (SM) as a source of health information during pregnancy have the potential to improve MHSB and access to healthcare services. However, the dissemination of inaccurate information may negatively impact maternal and fetal health outcomes. This study aimed to determine the prevalence of MHSB among pregnant women and its association with the use of SM, DH and tele-primary care systems. A crosssectional study of 385 pregnant women through stratified random sampling from selected maternal and child health clinics in Selangor was conducted from January to June 2022 using a validated selfadministered questionnaire. The findings indicated that 50.9% of pregnant women exhibited good MHSB, while the remaining proportion demonstrated lower engagement in information-seeking behaviour. The study also found a significant association between maternal age and MHSB (chi 2(1) = 5.889, p = 0.015) and the need for health information (chi 2(1) = 33.0, p < 0.001). A multivariate binary logistic regression analysis depicted that a one-unit increase in the need for health information raised the likelihood of engaging in MHSB by 1.040 times (AdjOR: 1.040; 95% CI: 1.023-1.058; p < 0.001). This study offers valuable insights into the MHSB of pregnant women in planning for potential strategies to enhance their access to accurate and relevant health information.
Patient safety culture is an essential element of healthcare quality, influencing clinical outcomes and patient well-being. Assessing healthcare professionals' practice, awareness, knowledge and attitudes toward patient safety are crucial for cultivating a culture of safety. This study focuses on validating a newly developed instrument designed to evaluate patient safety culture across these dimensions, providing a standardised tool for evaluating and improving safety practices in healthcare settings. A systematic literature review informed the development of the instrument's domains and items. Content validity was performed by subject matter experts, yielding good content validity index (CVI) values: relevance (0.988), simplicity (1.000), clarity (0.914) and ambiguity (0.901). Face validity index (FVI) was 0.802, based on feedback from medical officers. Modified kappa values ranged from 0.52 to 1.00, indicating fair to excellent agreement beyond chance. The finalised questionnaire was administered to 124 medical officers. The sphericity test by Bartlett was highly significant (p < 0.001), confirming the data's appropriateness for factor analysis, and sampling adequacy measures exceeded the 0.6 threshold. Exploratory factor analysis (EFA) showed that retained items had factor loadings above 0.6, affirming construct validity. The instrument demonstrated excellent internal consistency, with Cronbach's alpha exceeding 0.8 across constructs. Overall, the EFA and reliability assessment confirmed the robustness of the developed questionnaire. This result provides a good indication of reliability and the effectiveness of the instrument for assessing patient safety culture includes practices, awareness, knowledge and attitudes among healthcare professionals. This validated tool offers significant utility for assessing and improving patient safety culture among healthcare professionals, ultimately contributing to better patient care and safety outcomes in healthcare environments.
Car transfers for patients with mobility impairments are risky for caregivers due to constrained spaces and high biomechanical stresses. This study aimed to measure muscle activations and spine loads comparing the manual transfer method with a modified lifter prototype. Muscle activations at eight key muscles using surface electromyography and lumbar loads at the L5/S1 disk using full-body motion tracking, and force plates were evaluated. A total of 13 participants took part in the study. An Analysis of Covariance (ANCOVA) showed that patient weight significantly influenced lumbar loads while caregiver experience and height did not. After adjusting for patient weight, average peak axial compression forces and anterior-posterior (AP) shear forces were significantly lower when the lifter prototype was used (both p < 0.001). Significant reductions in muscle activations were also found with the lifter prototype for the left and right erector spinae longissimus (p < 0.001 and p = 0.028, respectively), left anterior deltoid (p = 0.007) and left biceps brachii (p = 0.003). This study provides the first biomechanical evaluation of car transfers on caregiver, highlighting the high loads experienced. The significant reductions in both lumbar loads and muscle activations with the prototype lifter prove that better interventions are needed to make this process safer for all parties involved.
Retropharyngeal abscess is rare in adults that can lead to severe complications. We presented the case of a foreign patient developed a life-threatening retropharyngeal abscess, complicated with language barriers and a missed migrating chicken bone. A 42-year-old foreigner man with unknown comorbid presented with upper airway obstruction in a day, and neck swelling for 5 days. History taking was difficult due to a language barrier. The patient's friend claims he experiencing sore throat, dysphagia and odynophagia for the preceding week. Examination showed biphasic stridor and diffused anterior neck swelling 5x5 cm, erythematous and warm. Flexible scope noted oedematous airway. Blood investigations showed sepsis. Patient intubated and urgent computed tomograpgy (CT) scan of the neck reported as extensive retropharyngeal collection. He underwent surgical drainage but the condition did not improve. Repeated CT scan revealed a migrating linear hyperdense foreign body at the C2/C3 level which was removed succesfully. Retropharyngeal abscess is a life-threatening condition with foreign body as a causative factor is uncommon in adults and can be challenging to detect, especially in the context of language barriers, thorough history taking, aided by imaging to locate the source of infection, led to the correct diagnosis and treatment.
A musical metronome is one method to assist the public in performing optimal chest compressions. This study evaluated the influence of innovative downbeat Fit-cardiopulmonary resuscitation (CPR) music versus no music on guiding laypersons to perform high-quality CPR. A randomised controlled trial was conducted among non-medical undergraduate students in Klang Valley, comparing a Fit-CPR music group (intervention) to standard CPR training (control). The intervention group received 90 minutes of hands-only CPR training, including a lecture, video presentation and three rounds of CPR practice with facilitators while listening to music. The control group underwent the same training without music. Primary outcomes included chest compression-associated components (rate, depth, recoil) and non-compression components (safety, response, help, breathing check, hand placement). Atotal of 53 students participated, with 27 (50.9%) in the intervention and 26 (49.1%) in the control group. Both groups showed significant improvement post-training (p < 0.001). The intervention group outperformed the control in compression and non-compression components (p = 0.008, p = 0.031). A significant association was found between the intervention and compression rate (p < 0.001), with 96.3% achieving the target rate compared to 53.8% in the control. However, no significant association was found for compression depth or recoil (p = 1.000, p = 0.498). This study demonstrates that Fit-CPR music helps laypersons to sustain the American Heart Association-recommended chest compression rate, highlighting its potential as an effective CPR training aid.
