Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine
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A 21-year-old woman developed severe muscle paralysis after sniffing toluene-containing thinner solution for 2 weeks. Her serum chemistries revealed severe hypokalaemia and a normal anion gap hyperchloraemic metabolic acidosis secondary to renal tubular acidosis. Her initial presentation mimicked hypokalaemic periodic paralysis, but toxicology screening of her blood and urine revealed the correct diagnosis of toluene poisoning. ⋯ On another occasion, apart from renal tubular acidosis, the patient also developed severe hypophosphataemia with the phosphate level decreasing to 0.15 mmol/L. Hypophosphataemia with such a low phosphate level after toluene poisoning has been rarely reported in the literature. Toluene inhalation can result in multiple electrolyte and acid-base abnormalities, and should be considered in the diagnosis of any young patient who presents with unexplained hypokalaemia and normal anion gap metabolic acidosis.
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To review literature on epidemiology, complications, diagnosis, and treatment of childhood obstructive sleep apnoea. ⋯ Consensus on the various important aspects of childhood obstructive sleep apnoea is still limited, especially the definition, diagnosis, and long-term sequelae of this condition. Further advances can only be made with international collaborative research, using evidence-based definitions, standardised techniques, and polysomnographic criteria.
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Case Reports
Delayed neuropsychiatric impairment after carbon monoxide poisoning from burning charcoal.
Poisoning by carbon monoxide from burning charcoal has become one of the popular and lethal ways of attempting suicide in Hong Kong. Survivors of the carbon monoxide poisoning often face acute and delayed adverse problems in both their physical and mental health. ⋯ The literature is reviewed regarding the aetiology, pathophysiology, and management of this condition. Regular monitoring of their neurocognitive function and forewarning of this potential complication to the survivors of carbon monoxide poisoning and their families should be essential.
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Comparative Study
Ethical attitudes of intensive care physicians in Hong Kong: questionnaire survey.
To examine the practice and ethical attitudes of intensive care doctors in Hong Kong and to compare findings with those from European studies. ⋯ The ethical attitudes of intensive care doctors in Hong Kong are similar to those of counterparts in Europe. However, Hong Kong doctors tend to involve families more often in the discussion of end-of-life issues.