Venous sinus thrombosis after the first dose of Pfizer BioNTech vaccine.

mRNA vaccines including Pfizer BioNTech and Moderna have categorically been considered safe when it comes to preventing COVID-19. However, there is still a small associated risk of thromboembolic phenomenon including venous sinus thrombosis with it and our case report highlights one.We describe a patient who developed severe progressive headache, tinnitus and visual disturbance symptoms post-Pfizer-SARS-CoV-2 vaccination. His medical history included essential tremors, hypertension, type 2 diabetes mellitus, chronic kidney disease stage 3, anxiety, depression and long-term catheterisation. Systemic examination revealed hypotonia, generalised reduced power and central diplopia along with peripheral visual field defect in the left eye. He was extensively investigated, the COVID-19 PCR test was negative and all routine blood tests were in the normal range except a marginally raised D-dimer of 779 ng/mL. CT head was unremarkable. He was also tested for myasthenia gravis; however, acetylcholine receptors antibodies were negative and nerve conduction studies were normal. Subsequent MRI of the brain with venography confirmed venous sinus thrombosis. A 24-hour Holter monitoring test did not reveal any cardiac rate or rhythm abnormality. He was treated with apixaban as per a neurologist's advice. His clinical condition started to improve and was later discharged from the hospital with an outpatient neurologist clinic follow-up.

Sexual Assault: A Descriptive Study of Victims Attending a Public Hospital in Ipoh

@#Introduction: Sexual assault continues to be a significant issue globally. It has a profound effect on the physical and emotional wellbeing of the victims. Methods: This is a retrospective study based on data collected from the ‘‘OneStop Crisis Centre’’ at Hospital Raja Permaisuri Bainun for the duration of 4 years from January 2011 to December 2014 aiming to highlight the pattern and prevalence of sexual assault in the city of Ipoh, Malaysia. Results: Ninety-six cases were reported with the age of the victims ranging from 4 to 63 years old. All the victims were female except for one. Forty-six of the victims were in the young adults category (19-30 years old) and six were above 30 years old. The mean (SD) age of the victims was 19.8 (7.9) years. Sixty-seven cases involved rape (69.8%) and 12 cases involved gang rape. Twelve cases were allegedly committed by relatives of the victim, 57 cases involved persons known to the victim and 27 cases (28.1%) were allegedly perpetrated by strangers. Most cases were reportedly committed at the victim’s’ own house (n=32). Conclusion: This study highlights the salient fact that most perpetrators were known by the victim. Rape was the commonest type of sexual assault and most victims were between the age of 19-30. The comprehensive recommendations for prevention of sexual violence put forward by the United States Centers for Disease Control and Prevention should be implemented by all relevant parties.