Dextrose 50% as a better substitute for saturated salt solution in mothball float test.

We describe the use of dextrose 50% solution to differentiate naphthalene and paradichlorobenzene in the mothball float test. Its advantages over saturated salt solution are discussed.

Acute renal failure and hepatitis following ingestion of carp gallbladder.

Introduction: Fish gallbladder has long been used as folk remedy in China. Poisoning due to carp gallbladder ingestion has been reported in many countries but the majority of cases are in Chinese journals. We report a case of grass carp gallbladder poisoning and review the literature, including the Chinese reports.

Sibutramine-induced acute myocardial infarction in a young lady.

Introduction: Sibutramine is an amphetamine-like drug used for its weight reducing effect. Sibutramine-induced acute coronary syndrome has rarely been reported. We report a case of myocardial infarction associated with the use of sibutramine.

Reversal of Brugada electrocardiographic pattern with sodium bicarbonate solution after amitriptyline overdose.

A Brugada electrocardiographic pattern (BEP) associated with tricyclic antidepressant (TCA) overdose has been reported rarely, but its reversal by sodium bicarbonate has not been described previously. We reported a case of amitriptyline overdose induced Type 1 BEP which was reversed by 150 mEq of intravenous sodium bicarbonate.

A case series of accidental ingestion of hand warmer.

Introduction: The use of hand warmers in Hong Kong during cold weather has become increasingly popular. Iron powder is one of the ingredients. We report the first cases of ingestion of hand warmer contents.

The destruction of the lower urinary tract by ketamine abuse: a new syndrome?

Objective: To report the clinical spectrum seen in young abusers of street-ketamine (regular recreational abusers of street-ketamine, for its hallucinogenic effects) in Hong Kong, presenting with significant lower urinary tract symptoms (LUTS) but with no evidence of bacterial infection.

Patients And Methods: We retrospectively analysed the clinical presentations, pelvic pain and urgency/frequency scores, video-urodynamic studies, cystoscopy findings, histological features of bladder biopsies and radiological findings of 59 ketamine abusers who were referred to the urology units of Princess Margaret and Tuen Mun Hospital, Hong Kong, from March 2000 to December 2007.

Results: Of the 59 patients, all had moderate to severe LUTS, i.

Effect of severe acute respiratory syndrome on bystander willingness to perform cardiopulmonary resuscitation (CPR)--is compression-only preferred to standard CPR?

Objective: The effect of the severe acute respiratory syndrome (SARS) outbreak on the willingness of laypersons to provide bystander cardiopulmonary resuscitation (CPR) using standard CPR (SCPR) or compression-only CPR (CCPR) was evaluated. The preferred type of SCPR in the post-SARS era was assessed.

Methods: A descriptive study was conducted through telephone interviews.

Evaluation of the performance of a modified Acute Physiology and Chronic Health Evaluation (APACHE II) scoring system for critically ill patients in emergency departments in Hong Kong.

Introduction: Numerous prognostic predictive models have been developed for critically ill patients, many of which are primarily designed for use in intensive care units. The objective of this study was to evaluate the accuracy of a modified Acute Physiology and Chronic Health Evaluation (APACHE II) scoring system in predicting the mortality for critically ill patients managed in emergency department (ED) resuscitation rooms in Hong Kong.

Method: A multi-centre, prospective study was conducted for patients managed in the resuscitation rooms of the EDs of four major hospitals, including one university teaching hospital.

The comparative impact of video consultation on emergency neurosurgical referrals.

Objective: Neurosurgical resources are concentrated in tertiary referral centers, whereas emergencies identified from district general hospitals are traditionally referred by telephone consultation (TC). Recent advances in communication technology offer the alternative options of teleradiology (TR) and video consultation (VC). This study aimed to determine the differences among these three consultation methods on the basis of their process-of-care indicators, clinical outcomes, and cost-effectiveness.

A clinical prediction rule for diagnosing severe acute respiratory syndrome in the emergency department.

Background: Accurate, objective models of triage for patients with suspected severe acute respiratory syndrome (SARS) could assess risks and improve decisions about isolation and inpatient treatment.

Objective: To develop and validate a clinical prediction rule for identifying patients with SARS in an emergency department setting.

Design: Retrospective analysis using a 2-step coefficient-based multivariable logistic regression scoring method with internal validation by bootstrapping.

How to minimize inappropriate utilization of Accident and Emergency Departments: improve the validity of classifying the general practice cases amongst the A&E attendees.

Studies have found that one-third to two-thirds of all patients attending Accident and Emergency (A and E) Departments could be managed appropriately by general practitioners (GPs). There is also evidence that referral to GPs can be acceptable to patients. The question of primary concern is screening non-urgent cases with high degrees of sensitivity (S), specificity (SP), and positive predictive value (PPV).

Doctor-based basic cardiopulmonary resuscitation course: an alternative to the conventional approach.

United Christian Hospital initiated a doctor-based cardiopulmonary resuscitation (CPR) Program. It is a two-hour, focused, adult CPR course, suitable for adults of different age groups and of different educational levels. The course was rated highly by the participants.