The impact of the door-to-antivenom time on the resolution of coagulopathy caused by green pit viper bite-a retrospective cohort study.

Trimeresurus albolabris (green pit viper) accounts for 95% of human venomous snakebites in Hong Kong and the Green Pit Viper antivenin has become the only antivenom available. Little is known about the impact of early antivenom administration on the duration of venom-induced coagulopathy. This retrospective study aimed to evaluate the impact of the door-to-antivenom time (DTAT) on the duration of such coagulopathy.

Effectiveness of BNT162b2 and CoronaVac vaccinations against mortality and severe complications after SARS-CoV-2 Omicron BA.2 infection: a case-control study.

Data regarding protection against mortality and severe complications after Omicron BA.2 infection with CoronaVac and BNT162b2 vaccines remains limited. We conducted a case-control study to evaluate the risk of severe complications and mortality following 1-3 doses of CoronaVac and BNT162b2 using electronic health records database.

Cost-Effectiveness of Midazolam Versus Haloperidol Versus Olanzapine for the Management of Acute Agitation in the Accident and Emergency Department.

Objectives: A multicenter randomized clinical trial in Hong Kong Accident and Emergency (A&E) departments concluded that intramuscular (IM) olanzapine is noninferior to haloperidol and midazolam, in terms of efficacy and safety, for the management of acutely agitated patients in A&E setting. Determining their comparative cost-effectiveness will further provide an economic perspective to inform the choice of sedative in this setting.

Methods: This analysis used data from a randomized clinical trial conducted in Hong Kong A&E departments between December 2014 and September 2019.

Serum ceruloplasmin monitoring in a case of silver intoxication due to intravenous silver infusion.

Introduction: Colloidal silver packaged as a dietary supplement is readily available online and is thought to be safe. Literature describing its toxicity in humans is scarce.

Case Report: A 47-year-old man presented to us for sensory and gait problems.

Intramuscular midazolam, olanzapine, or haloperidol for the management of acute agitation: A multi-centre, double-blind, randomised clinical trial.

Background: The safety and effectiveness of intramuscular olanzapine or haloperidol compared to midazolam as the initial pharmacological treatment for acute agitation in emergency departments (EDs) has not been evaluated.

Methods: A pragmatic, randomised, double-blind, active-controlled trial was conducted from December 2014 to September 2019, in six Hong Kong EDs. Patients (aged 18-75 years) with undifferentiated acute agitation requiring parenteral sedation were randomised to 5 mg intramuscular midazolam ( = 56), olanzapine ( = 54), or haloperidol ( = 57).

Acupuncture in the emergency department: a systematic review of randomised controlled trials.

Introduction: A comprehensive review of both English and Chinese language literature to inform acupuncture practice in emergency department (ED) settings is lacking. Accordingly, we aimed to conduct a systematic review of English and Chinese randomised controlled trials (RCTs) of acupuncture use in the ED.

Methods: Four English databases (Embase, PubMed, AMED and CENTRAL) and two Chinese databases (CNKI and Wanfang) were systematically searched using the keywords 'acupuncture' and 'emergency department', followed by a bibliographic search of references.

Raised troponin I in Chinese patients with acute pulmonary embolism suggests complicated clinical course and may predict intensive care unit admission.

Introduction: Acute pulmonary embolism (PE) is an uncommon but potentially fatal disease. Acute right ventricular failure, which can be demonstrated by echocardiography, is known to be an adverse prognostic factor in patients with acute PE. However, this diagnostic test is not always available in emergency departments and it is also an operator-dependent investigation.

Metformin-associated lactic acidosis in Chinese patients with type II diabetes.

Metformin is a widely used antidiabetic agent that is generally considered safe. However, metformin-associated lactic acidosis (MALA), though not common, occurs from time to time and results in significantly high mortality. A series of 23 MALA cases in a local major hospital in Hong Kong is reported in this article to demonstrate the epidemiological data, risk factors, clinical features as well as the clinical outcomes for better understanding of this disease entity.

Development and validation of a high-throughput double solid phase extraction-liquid chromatography-tandem mass spectrometry method for the determination of tetrodotoxin in human urine and plasma.

A sensitive analytical method for the determination of tetrodotoxin (TTX) in urine and plasma matrices was developed using double solid phase extraction (C18 and hydrophilic interaction liquid chromatography) and subsequent analysis by HPLC coupled with tandem mass spectrometry. The double SPE sample cleanup efficiently reduced matrix and ion suppression effects. Together with the use of ion pair reagent in the mobile phase, isocratic elution became possible which enabled a shorter analysis time of 5.