Synchronous laparoscopic low anterior and transanal endoscopic microsurgery total mesorectal resection.

Background: Laparoscopic low anterior resection (Lap LAR) and total mesorectal excision (TME) is the standard minimally invasive surgery (MIS) for mid and low rectal tumours. However, the pelvic resection in particular for bulky tumour in the narrow male pelvis has always been a challenge for surgeons. Transanal endoscopic microsurgery (TEM) is a well-established technique and synchronous abdomino-perineal excision of rectum (APER) is also a standard procedure.

Tuberculous pericarditis presenting as massive haemorrhagic pericardial effusion.

Tuberculous pericarditis is an exceedingly rare but a well-described extra-pulmonary manifestation of tuberculosis (TB) infection in Hong Kong. An 82-year-old woman with a known history of diabetes mellitus, hypertension and hyperlipidaemia was admitted for congestive heart failure. Routine echocardiographic study during admission revealed a massive pericardial effusion (~4 cm in thickness) but with no tamponade effect.

Job satisfaction and the association with involvement in clinical activities among hospital pharmacists in Hong Kong.

Objectives: To describe the relationship between job satisfaction of hospital pharmacists and the extent of their involvement in clinical pharmacy activities, and to examine if demographics and practice characteristics are associated with the extent of involvement in clinical pharmacy activities and job satisfaction.

Methods: A cross-sectional study was conducted by surveying with a self-administered questionnaire mailed to all full-time pharmacists employed by the Hospital Authority, Hong Kong.

Key Findings: Respondents reporting job and career satisfaction averaged near the neutral point.

Feasibility study on single-port access (SPA) laparoscopic cholecystectomy using transanal endoscopic microsurgery (TEM) instruments.

Transanal endoscopic microsurgery (TEM) is a procedure for the treatment of rectal villous adenoma and early rectal tumours. It is actually the first single port access surgery (SPA) as well as a true Natural Orifice Transluminal Endoscopic Surgery (NOTES) in standard use for the last twenty years. The use of this technique and instrumentation in cholecystectomy is revisited.

Effects of deep and superficial heating in the management of frozen shoulder.

Objectives: To determine whether the addition of deep or superficial heating to stretching produces better clinical outcomes than stretching alone in the management of frozen shoulder.

Design: A single-blinded, randomized controlled study.

Subjects: Thirty subjects suffering from the stiffness phase of frozen shoulder.

Health literacy, complication awareness, and diabetic control in patients with type 2 diabetes mellitus.

Aim: This paper is a report of a study to examine the relationship between health literacy, complication awareness and diabetic control among patients with type 2 diabetes mellitus, and to validate a Chinese version of the Short-form Test of Functional Health Literacy in Adults.

Background: There is a rapidly increasing trend in the prevalence of diabetes mellitus in Asian countries. Alongside the considerable progress in recent decades of health education in the field of diabetes care, the effects of health literacy and complication awareness have received increasing attention over the past 10 years.

MicroAlbuminuria Prevalence Study (MAPS) in hypertensive type 2 diabetic patients in Hong Kong.

Objectives: To assess the prevalence of macroalbuminuria and microalbuminuria, and the level of blood pressure control in patients with type 2 diabetes and hypertension in Hong Kong.

Design: Cross-sectional clinic-based epidemiological study.

Setting: Six medical centres (including two public hospital diabetes centres) in Hong Kong.

Delayed cholestatic hepatitis due to methimazole.

We report on a 71-year-old man who presented to the medical department of Our Lady of Maryknoll Hospital with progressive cholestatic hepatitis. Tests for hepatitis viral markers gave negative results and ultrasonography revealed no dilated bile ducts. Endoscopic retrograde cholangiopancreatography showed a normal biliary tree.

A young male patient with persistent fever due to tuberculous peritonitis.

Tuberculous peritonitis is an uncommon disease in Hong Kong. We report a case of tuberculous peritonitis in a young male. The patient presented with persistent fever and intermittent cough for 1 month, but had no gastrointestinal symptoms.

Hypothyroidism presenting as hypercholesterolaemia and simvastatin-induced myositis.

We report on a 50-year-old woman who presented with hypertension. She was given simvastatin for hypercholesterolaemia. The creatine kinase level was 3180 U/L at the 3-month follow-up visit, which was thought to be due to simvastatin treatment.

Bilateral segmental neurofibromatosis with partial unilateral lentiginosis.

A 73-year-old woman presented with numerous cutaneous neurofibromas on the trunk in a bilateral dermatomal distribution (T2-T12). She also had multiple lentigines scattered on the left side of the trunk, affecting the T2-T12 dermatomes. The diagnosis of bilateral segmental neurofibromatosis (NF) was made on the basis of the clinical features and distribution of the neurofibromas and an absence of family and systemic involvement.

Case report: anti-proteinase 3 antibody activity in a patient with primary sclerosing cholangitis: clinical remission following ursodeoxycholic acid therapy.

Primary sclerosing cholangitis is rare among Chinese. We report on a 71 year old male patient who presented with clinical features consistent with the disorder. Subsequent investigations confirmed the diagnosis.

Peutz-Jeghers syndrome associated with primary malignant melanoma of the rectum.

An 85-year-old Chinese woman was found to have mucocutaneous pigmentation involving the lips, buccal mucosa, hard palate and the buttocks when she presented with primary malignant melanoma of the rectum. Multiple brown-black pigmentation was also noted in the anal canal and the adjacent mucosa surrounding the tumour. This is the first report of Peutz-Jeghers syndrome associated with malignant melanoma of the rectum.