Workplace breastfeeding support for hospital employees.

Background: Breastfeeding initiation rates have been steadily rising in Hong Kong, but most employed women wean prior to returning to work. While health care providers promote breastfeeding, women receive little support from employers. A few health care facilities offer some workplace breastfeeding support, but little is known about the specific types and amount of support that are offered.

Refining clinical practice: transforming science research into the art of medicine.

This article traces the development of modern day breast cancer treatment from 1896 when observations were made on the positive response of patients to oophorectomy. The oestrogen receptor was defined and tamoxifen was discovered to be an effective anti-oestrogen. The genes related to breast cancer, BRCA1 and BRCA2, were found to confer high risks of breast and ovarian cancer on women with these genes.

Declines in tobacco brand recognition and ever-smoking rates among young children following restrictions on tobacco advertisements in Hong Kong.

Background: We compared the recognition of tobacco brands and ever-smoking rates in young children before (1991) and after (2001) the implementation of cigarette advertising restrictions in Hong Kong and identified continuing sources of tobacco promotion exposure.

Methods: A cross-sectional survey of 824 primary school children aged from 8 to 11 (Primary classes 3-4) living in two Hong Kong districts was carried out using self-completed questionnaires examining smoking behaviour and recognition of names and logos from 18 tobacco, food, drink and other brands common in Hong Kong.

Results: Ever-smoking prevalence in 2001 was 3.

Role of coagulation testing in predicting bleeding risk.

Coagulation testing is employed widely prior to open surgery and invasive procedures. This is based on the assumption that such testing is of clinical value in the prediction of bleeding. In order to improve the clinical understanding of the potential limitations of first-line coagulation tests used in this way, we have systematically reviewed the literature that addresses the value of routine coagulation testing in helping to predict bleeding risk.

Culture and dementia: accounts by family caregivers and health professionals for dementia-affected elders in South Korea.

With rapidly growing concerns about the high rates of dementing illness in Korea, this study presents findings from in-depth qualitative interviews with fifteen family caregivers and health professionals on: (1) perceptions of dementia among Korean family caregivers, (2) cultural influences on caregiving, and (3) status of the development and utilization of formal services for the older population with dementia in Korea. Practices of the traditional familism are demonstrated in the multigenerational family where both material support and respect for the aged are the social norm. Thus, providing informal care for a demented parent is expected in the context of fulfilling filial responsibilities.

The pharmacological treatment of schizophrenia in Chinese patients: a comparison of prescription patterns between 1996 and 1999.

Aims: In 1996 a Hong Kong-wide survey of pharmacological treatment for schizophrenic inpatients identified a few idiosyncratic prescription patterns that were not consistent with international standards. In the context of continuous quality assurance, the survey was repeated in 1999 to monitor trends in the pharmacotherapy of schizophrenia and to identify changes in prescribing practices. It was expected that the widespread introduction of novel antipsychotic drugs coupled with continuing medical education would favourably alter prescribing habits.

General medicine--revisited, rejuvenated, revitalized and reemphasized.

Introduction: The swing of the pendulum towards medical subspecialties, which are mainly organ-based, was inevitable. Over 30 years ago, this problem surfaced in the United States (US). The fragmentation of medicine had its advantages and disadvantages.

Transient hyperthyroidism of hyperemesis gravidarum.

Objective: To characterise the clinical, biochemical and thyroid antibody profile in women with transient hyperthyroidism of hyperemesis gravidarum.

Design: Prospective observational study.

Setting: Hospital inpatient gynaecological ward.

Rare acquired bleeding disorders.

Accurate diagnosis of the cause of bleeding is a prerequisite for determination of the optimal therapeutic response. Clinicians are generally aware of the more prevalent hemorrhagic syndromes but some rare acquired conditions are also of importance. In many of these, inhibitors of coagulation factors or of platelet adhesion/aggregation cause bleeding.

Inferior vena cava malformation as a risk factor for deep venous thrombosis in the young.

Conditions which result in hypercoagulable blood or venous stasis may predispose to the development of deep vein thrombosis (DVT). Most of the recently described risk factors for DVT induce a hypercoagulable state. Over a 3-year period we have observed anomaly of the inferior vena cava (IVC) in four young patients presenting with spontaneous unprovoked DVT.

The management of retroperitoneal soft tissue sarcoma: a single institution experience with a review of the literature.

Aim: Ten percent of soft tissue sarcomas (STS) arise in the retroperitoneal tissues. The prognosis for patients with retroperitoneal sarcoma is poor with a 5-year survival rate between 12% and 70%. Stage at presentation, high histological grade, unresectable primary tumour and incomplete resection are associated with a less favourable outcome.

Sight-threatening varicella zoster virus infection after fludarabine treatment.

Varicella zoster virus (VZV) infection involving the posterior segment of the eye after fludarabine treatment has not previously been described. Two patients, who had completed fludarabine treatment 3 and 18 months previously, presented with visual loss that had been preceded by a recent history of cutaneous zoster. The use of the polymerase chain reaction (PCR) for VZV DNA from ocular specimens allowed rapid confirmation of clinical diagnosis and treatment with a good outcome in one patient.

Fusion of coregistered cross-modality images using a temporally alternating display method.

As an aid to the interpretation of functional images, cross-modality coregistration of functional and anatomical images has grown rapidly. Various ways of easily interpreting and visualising coregistered images have previously been investigated; for their display, an intensity-weighted temporally alternating method is used. For brain images, geometric registration involves the automatic alignment method, using the head scalp boundary extracted from the sinogram of a PET emission scan and a surface-matching algorithm; images of the chest or abdomen are registered semi-automatically using a paired point matching algorithm.

Newly developing endoscopic devices--shadow optics and micromachine.

Based on the newly-developed engineering technologies, many kinds of useful equipment have been available for minimally invasive surgery. Recently the time to connect clinical needs and advanced technologies has become faster. In this article, we have summarized the recent technologies for endoscopic surgeries.

The development of postgraduate training programmes in Singapore.

Singapore is a small country compared to Pakistan. Being an urban modern developed nation with a high population density, adequate doctors (& specialists), and good infrastructure, it has one medical school enrolling 200 students annually, one Graduate School of Medical Studies (GSMS) responsible for entry postgraduate examinations (the M Med) and one Academy of Medicine (AM) responsible (jointly with the Graduate School) for exit certification/examinations (FAMS) into 35 specialties. There is also one College of Family Physicians with a significant role in the training of Family Physicians jointly with the Graduate School.

Long-term outcome and disease control in near-fatal asthma.

Patients who have survived an episode of intubation and mechanical ventilation for acute respiratory failure due to a severe and unresponsive asthmatic attack are considered to have experienced a near-fatal asthma (NFA) attack. Such patients are at a higher risk of similar severe attacks and hence of death in the future. The aims of the study were to: (i) evaluate the outcome; (ii) identify any persistent deficiencies in asthma management, and (iii) assess self-management knowledge in survivors of NFA.

The natural history of dengue illness based on a study of hospitalised patients in Singapore.

Aim Of Study: To study the clinical features of dengue illness in hospitalised patients in Singapore.

Methods: One-hundred and thirty hospitalised patients with serologically confirmed dengue illness, from 1 April 1992 to 31 October 1992, were analysed retrospectively.

Results: Teenagers and young adults between 15 to 30 years of age were most commonly affected.