United Christian Hospital is an acute district general hospital in Kwun Tong of New Kowloon in Hong Kong, operated by the Hospital Authority. The hospital has 1,174 beds and staff of 3,000, serving eastern Kowloon.Founded in 1973, it has links to Alice Ho Miu Ling Nethersole Hospital via the Hong Kong Christian Council. The hospital's first chief medical superintendent was Dr. Edward Hamilton Paterson.
OBJECTIVES:Social cognitive impairments were well-documented in schizophrenia and individuals with clinical high risk for psychosis (CHR). While eye movement abnormalities during gaze perception in schizophrenia have been suggested, such understanding in individuals with CHR is limited. DESIGN, SETTINGS AND PARTICIPANTS:This study recruited 36 CHR individuals and 50 healthy controls (HC) to perform a gaze perception task with eye-tracking techniques analyzed with hidden Markov models for predictability and pattern recognition. Eye movement variables and behavioral responses, self-referential gaze perception (SRGP) rates, were compared between groups and examined with discriminant analyses. Associations between eye movements and SRGP rates with multiple symptom dimensions and social functioning were examined. RESULTS:Results indicated that CHR group displayed nose-focused (vs eye-focused) and erratic eye movement patterns compared to HC. The combination of behavioral and eye movement variables exhibited a discriminatory ability of 0.893 area under the curve (AUC) in classifying CHR and HC, significantly outperforming models using either SRGP rates (AUC = 0.824) or eye movement variables (AUC = 0.781) alone. The combined model achieved high sensitivity (0.861) and specificity (0.820), with eyes-nose scale, fixation duration, and ambiguous SRGP rate emerging as the most discriminative features. Self-referential gaze perception rates were primarily associated with schizotypy and social anxiety, while eye movement patterns were mainly associated with delusional ideations and social functioning. CONCLUSIONS AND RELEVANCE:This study comprehensively examined eye movement patterns during gaze perception in CHR and their associations with clinical manifestations, suggesting the potential of visual attention patterns as both diagnostic biomarkers and therapeutic targets in the CHR population.
Background: Most of the public hospitals in Hong Kong provide a regular colorectal endoscopic submucosal dissection (ESD) service. The current retrospective study aims to review the long- and short-term outcomes of these services, so as to identify areas for improvement. Method and Results: From January 2017 to March 2020, 634 lesions in 623 patients were removed by an ESD technique in seven endoscopic units. The mean lesion size was 31 mm (SD 13 mm, range 10–95 mm), and the mean procedure time was 121 min (SD 67 min). En bloc resection and R0 resection could be achieved in 91.3% and 79.3% of the lesions, respectively. The intra-procedure perforation rate was 12.3%. The delayed bleeding rate was 2.1%, and the delayed perforation rate was 0.8%. Only 0.9% (6/634) of the procedures needed emergency surgical salvage due to complications. Most of the lesions were adenomas (564/634), and 55 of them were adenocarcinomas. The cumulative local recurrence rate was 4.0% at a mean follow-up of 34 months. In multivariate analysis, longer procedure time, submucosal fibrosis, hybrid ESD and piecemeal removal were associated with intra-procedure perforation. Risk factors for failed en bloc resection included non-granular and polypoid morphology, colonic location, longer procedure time and low centre volume. Malignant pathology without salvage surgery was the only independent risk factor for local recurrence. Conclusions: Colorectal ESD has been carried out in Hong Kong with acceptable short-and long-term outcomes despite the technique still being in the learning phase in some centres. Potential areas for improvement should include targeted training to speed up the procedure and enable better handling of difficult cases, aiming to decrease the perforation rate and local recurrence.
Spinocerebellar ataxia (SCA) is a group of progressive neurodegenerative diseases. These patients often suffer from pain with multiple etiologies. Our patient suffers from distressing neuropathic back pain, which was only marginally alleviated with high-dose conventional antineuropathic agents while suffering from the side effects. A course of scrambler therapy was prescribed, and sustained relief of neuropathic back pain was achieved for at least eight weeks after completion of scrambler therapy. This is the first case of neuropathic pain in SCA to be treated with scrambler therapy, to the best of our knowledge. Compared with usual daily scrambler therapy sessions, our patient received twice-daily sessions. The main takeaways from our case are that 1) scrambler therapy is a potential treatment for neuropathic pain in SCA patients; 2) it can treat neuropathic pain refractory to conventional antineuropathic agents with the added benefit of reducing the requirement as well as side effects associated with conventional antineuropathic agents; and 3) twice-daily sessions are a potential alternative to standard daily sessions with positive logistical implications.
Abstract Background Snakebite envenomation is a priority neglected tropical disease according to the World Health Organization. To address the issue, enhanced epidemiological evidence in endemic countries and an improved availability of snake antivenoms were proposed. Objectives To understand the local epidemiology of snakebite cases, promote awareness of potential snakebite injuries in our locality, and provide insight on the presentation and management of these injuries. Methods An epidemiological study reviewing cases between 2012 and 2021 in our Hong Kong Poison Information Center (HKPIC) database was conducted. Snakebite cases from 1 January 2012, to 31 December 2021, were identified from the HKPIC database, by using “snake” as the poison name or category. Results A total of 592 cases were captured, approximately 59 cases per year. The top recognised offending snake was Green Pit Viper (Trimeresurus albolabris) (71.8%) followed by Chinese Cobra (Naja atra) (3.2%), and Many‐Banded Krait (Bungarus multicinctus) (2.2%). Native non‐venomous or minimally venomous snakes accounted for 4.1% and pet snakes for 2.5%. Snakebites most often occur during summer and autumn, between 7 and 9PM, in rural neighborhoods. Work‐related bites accounted for 19.3% of cases. Local cytotoxicity was seen in 88%, haemotoxicity in 45.3%, and neurotoxicity in 1.5% cases. Antivenom was administered in 58.1% cases, the acute allergic reaction rate was 3.5%. Conclusions Life‐threatening severe cytotoxicity, haemotoxicity, and neurotoxicity were observed following native snakebites in Hong Kong. GPV was the commonest observed snakebite in our locality, accounting for 71.8% cases. The general principles of prompt medical care, snake envenomation recognition, and consideration of early antivenom treatment are all critical steps in reducing snakebite mortality and morbidity.
