Since January 1992, all benzodiazepines have been classified as dangerous drugs under the Dangerous Drugs Ordinance in Hong Kong. This legislative provision requires medical practitioners and pharmacists to keep a detailed record of their prescriptions of benzodiazepines The present study looks at the impact of the provision on prescribing trends in the Hong Kong population and in a general psychiatric clinic. A comparison of the 1991 (baseline level) and 1994 figures reveals a 50% and a 10% reduction in the average yearly number of benzodiazepine prescriptions per person in the Hong Kong population and in the general psychiatric clinic, respectively. In particular, triazolam prescriptions had the greatest reduction. The findings are discussed in light of the possible changes of prescribing practice by medical practitioners after the new legislative provision came into effect.

Staphylococcus aureus is an important cause of exit site infections and peritonitis in patients receiving continuous ambulatory peritoneal dialysis. To determine the role of Staphylococcus aureus nasal carriage in determining the rate of Staphylococcus aureus exit site infection and peritonitis, we studied 177 continuous ambulatory peritoneal dialysis patients who were followed up at Queen Mary Hospital from January 1990 through June 1995. The cumulative rate of exit site infection was one episode per 11.5 patient months. The cumulative rate of peritonitis was one per 19.2 patient months. The total number of patients with one or more positive cultures of Staphylococcus aureus from the anterior nares was 30 (16.9%). There is a significant association of the Staphylococcus aureus nasal carriage status with Staphylococcus aureus exit site infection and peritonitis. Moreover, there seems to be a trend for the Staphylococcus aureus nasal carrier to run a higher risk of multiple episodes of Staphylococcus aureus-related infections. Thus for this group of patients, decolonisation of Staphylococcus aureus from the anterior nares with local or systemic antibiotics may be useful.

The medical records of patients with chronic bullous dermatosis who have attended the Social Hygiene Service in Hong Kong were reviewed retrospectively. All skin biopsy reports in the Social Hygiene Service (Dermatology) for patients with a diagnosis of vesiculo-bullous disease were retrieved along with the respective medical records for the period from January 1985 through December 1992. The epidemiology, treatment, course, and prognostic data were reviewed. Of 234 patients with chronic bullous disease, the three most common diagnoses were bullous pemphigoid (n=149, 63.7%), pemphigus vulgaris (n=38, 16.2%), and pemphigus foliaceus (n=23, 9.9%). Only six patients (2.6%) had dermatitis herpetiformis, and another six had linear immunoglobulin A disease (2.6%). Systemic steroids (40-80 mg/day) were the mainstay of therapy for pemphigus and pemphigoid patients. The most common steroid-sparing agent employed was azathioprine. Dapsone was the treatment of choice for dermatitis herpetiformis and gluten-free diet was not employed for control of the skin condition in these patients.

This survey was designed to study the problem of hospital readmission in a geriatric centre in Hong Kong. A retrospective survey of 565 unplanned admissions to a geriatric department showed that the rate of unplanned readmission was 25.3%. Only 56.7% of the selected hospital records could be retrieved for further analysis. Of the unplanned readmissions, 19% were potentially avoidable. The reasons for readmission included medication problems (2.5%), inadequate medical management (16.5%), natural clinical course (32.9%), and new clinical problem (48.1%). A statistical difference was found in the readmission rates for those patients with or without multiple admissions in the previous year (P = 0.001). Those patients who presented with cardiovascular problems were also more likely to be readmitted, although this difference was not statistically significant.

The cervical smear is effective in detecting the precursor lesions of cervical cancer. With appropriate treatment invasive carcinoma may be prevented. For a smear to have maximum diagnostic value, it must contain sufficient numbers of well-preserved cells from the transformation zone of the cervix where most malignancies develop. A major cause of a non-diagnostic smear is poor sampling. A new sampling device, the Cervex-Brush, has been touted as being capable of producing a superior specimen compared with the modified Ayre's spatula, which is the most widely used cervical sampler in Hong Kong. When evaluated on 500 women presenting for a smear at a community cervical screening clinic, the Cervex-Brush was found to produce a good quality sample as judged by the presence of endocervical and/or metaplastic cells, lack of blood, and the thickness of the cell sample. In the drive to ensure that cervical smears are of the highest quality, the Cervex-Brush is worthy of further evaluation for routine use. Although it is significantly more expensive, the extra costs could be offset by the substantial savings that can accrue from having a smaller number of substandard samples and the need to repeat smears.