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.
