COVID-19 vaccine hesitancy and its associated factors in Malaysia.

The success of the COVID-19 vaccination programme to achieve herd immunity depends on the proportion of the population inoculated. COVID-19 vaccination hesitancy is a barrier to reaching a sufficient number of people to achieve herd immunity. This study aims to determine the prevalence of COVID-19 vaccine hesitancy and to identify the reasons contributing to vaccine hesitancy using the Theory of Planned Behavior.

The lived experiences of a COVID-19 immunization programme: vaccine hesitancy and vaccine refusal.

Background: The COVID-19 pandemic has resulted in a global health emergency and lock-down measures to curb the uncontrolled transmission chain. Vaccination is an effective measure against COVID-19 infections. In Malaysia amidst the national immunisation programme (NIP) which started in February 2021, there were rising concerns regarding the prevalence of vaccine hesitancy and refusal, and therefore, vaccine uptake among Malaysians.

The role of emergency ultrasound for evaluating acute pyelonephritis in the ED.

Background: Controversy remains over the imaging method of choice for evaluating acute pyelonephritis (APN) in the emergency department (ED).

Objective: The aim of the study was to determine the efficacy of ultrasound in the diagnosis and management of patients presented to the ED with APN.

Methods: This was a retrospective study of prospectively collected data.

Painless aortic dissection masquerading as brainstem stroke with catastrophic anticoagulant use.

Painless aortic dissection with only focal neurological symptoms and signs can be a great challenge to the emergency physician. Inadvertently and erroneous treatment of stroke may threaten patient's life. We present a patient with painless aortic dissection (DeBakey I), which was initially misdiagnosed as brainstem stroke with catastrophic anticoagulant use.

Comparing different patterns for managing febrile children in the ED between emergency and pediatric physicians: impact on patient outcome.

Objective: The management of children with fever of indefinite source still remains controversial. This study aimed to compare different practice patterns between pediatric physicians (PPs) and emergency physicians (EPs) in the management of pediatric fever in the emergency department (ED) and correlate them to existing practice guidelines. Their impact on patient outcomes was also discussed.

Neurogenic pulmonary oedema misdiagnosed as acute myocardial infarction in a comatose patient.

Introduction: We report a case of neurogenic pulmonary oedema (NPO) following massive left cerebral infarct, which was initially misdiagnosed as acute myocardial infarction (AMI).

Clinical Picture: This 52-year-old man presented with acute loss of consciousness with normal brain computed tomography (CT). He was treated as non-ST-elevation AMI complicated with pulmonary oedema based on findings of chest radiograph (bilateral pulmonary oedema), electrocardiogram (marked ST-T changes in leads V3 to V6), and cardiac enzymes [elevated creatinine kinase (CK) and CK-MB].

Cavernous sinus thrombophlebitis masquerading as ischaemic stroke: a catastrophic pitfall in any emergency department.

Cavernous sinus thrombophlebitis is a clinically rare but fatal disease that progresses rapidly. Its initial presentation is always neglected by emergency physicians, until typical symptoms and signs are noted or thin-slice brain CT results obtained, by which time it is already too late. A case of cavernous sinus thrombophlebitis caused by sinusitis, which initially masqueraded as ischaemic stroke, is reported.

Ruptured left subclavian artery aneurysm presenting as upper airway obstruction in von Recklinghausen's disease.

Aneurysms arising from the subclavian artery are very rare vascular abnormalities in von Recklinghausen's disease, which often have a silent clinical presentation and are difficult to diagnose before rupture. We report a case of von Recklinghausen's disease with life-threatening upper airway obstruction caused by spontaneous rupture of the left subclavian artery aneurysm in a 46-year-old woman. The diagnosis was eventually confirmed by a reconstructed enhanced computed tomography of aorta.