Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine
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To determine optimal perioperative antithrombotic management for patients with cardiac diseases undergoing joint replacement surgeries. ⋯ The perioperative management of patients with cardiac diseases in receipt of antithrombotic agents is based upon a delicate balance between the perceived risk of arterial thromboembolism and the perceived risk of perioperative bleeding. One must exercise good judgement in deciding the most appropriate perioperative antithrombotic regimen. Venous thromboembolism is also a common problem after joint replacement surgeries. For patients already on aspirin, optimal venous thromboembolism prophylaxis is still being debated.
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To audit the use of intrauterine balloon tamponade for the management of massive postpartum haemorrhage and compare outcomes with those documented in the literature. ⋯ Bakri balloon tamponade is an effective means of managing massive postpartum haemorrhage, and should be adopted in protocols to manage such patients.
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Ketamine is a relatively new recreational drug used by youngsters in recent decades. Its toxic effects on the genitourinary system were first reported in 2007, and now attract extensive attention from urologists, pharmacologists, and toxicologists all over the world. As many front-line health professionals and medical social workers are still unaware of this new clinical entity and an increasing number of the drug users seek help for urological symptoms, this mini-review aimed to summarise the clinical features and possible mechanisms of ketamine-induced genitourinary toxicity. By raising public awareness of these toxic effects, the authors hope that the contents of this review will be widely disseminated not only to medical professionals, but also to relevant government departments and the general public.
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To review acute angle closure attacks induced by local and systemic medications. ⋯ Since acute angle closure attack is a potentially blinding eye disease, it is extremely important to be vigilant and aware of ophthalmic and systemic medications that can lead to such attacks in predisposed subjects and to diagnose the condition when it occurs.
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Local anaesthetic administration is a common clinical practice not only in the operating theatres, but also in other clinical settings. Relevant monitoring and resuscitation facilities in certain clinical settings outside the operation rooms may not be optimal. ⋯ This article reviews the pharmacology of local anaesthetics, clinical features of systemic toxicity resulting from their local use, and necessary preventive measures and management. The role of lipid emulsion therapy is also discussed.