Aspirin is a non-steroidal anti-inflammatory drug that has potent antiplatelet actions. Aspirin was initially used as an analgesic and antipyretic drug before its anti-inflammatory properties were discovered. Aspirin also has antithrombotic effects due to the inhibition of cyclo-oxygenase activity in platelets, which reduces the extent of thromboxane A2 formation and consequently the aggregability of platelets. Prophylactic low-dose aspirin therapy reduces the risk of future cardiovascular events in a variety of clinical settings. The maximum effect of aspirin in reducing risks of myocardial infarction is achieved soon after the initiation of therapy. The selective inhibition of platelet thromboxane A2 may be the pharmacological basis for the effectiveness of aspirin in treating pregnancy-induced hypertension. Aspirin can virtually abolish thromboxane A2 production in patients receiving fish oil. Thus, aspirin has been and will be the standard reference compound for long-term oral treatment of platelet hyperactivity, most notably in the secondary prevention of myocardial infarction.

A retrospective study of all deliveries from 1983 to 1993 at the Tsan Yuk Hospital to evaluate the incidence was performed and outcome of eclampsia. Eclampsia occurred in 12 patients. The incidence was approximately 2 per 10 000 deliveries and was relatively constant during the study period. Most convulsions occurred during the intrapartum (41.7%) and post-partum (50.0%) periods, and about half of them had no warning signs. There were no maternal or perinatal deaths. Prophylactic anticonvulsants should be given to all patients with warning signs; however, eclampsia is not always preventable.

The new Hong Kong Coroners Ordinance was published in April 1997. It introduced an expanded set of guidelines for reporting deaths to the coroner as well as the threat of criminal proceedings for non- compliance. The Ordinance is due to be implemented in early 1998. The aim of this study is to determine the likely effect of the new law on the relative proportion of coroner’s and hospital (consent) autopsies. A total of 352 consecutive autopsy cases were reviewed; 170 (48.3%) were referred for coroner’s autopsies and 182 (51.7%) for hospital autopsies. By applying the criteria of the current ordinance, there should have been 213 (60.5%) coroner’s autopsies and 139 (39.5%) hospital autopsies—that is, 43 hospital autopsies should have been coroner’s autopsies. Under the new Coroners Ordinance, there would be 300 (85.2%) coroner’s autopsies and only 52 (14.8%) hospital autopsies. The new Coroners Ordinance is likely to result in a greater number of requests for coroner’s autopsies with a corresponding decline in hospital autopsies—in our case, a shift from 48.3% of all autopsies performed to 85.2%! This increase would be due largely to the requirement for reporting stillbirths but would also be due to increased reporting for fear of ‘criminal proceedings’ for non-compliance. An absolute increase in the number of autopsies is also anticipated, although the magnitude cannot as yet be predicted.

The stenosis and subsequent thrombosis of the arteriovenous fistula may lead to a loss of vascular access sites; this a major problem in chronic haemodialysis patients. Percutaneous transluminal angioplasty has been a popular way of correcting such lesions in recent years. We have reviewed patients who underwent this operation from 1993 to 1996 at the Queen Mary Hospital. Among 11 patients who were documented as having arteriovenous fistula stenosis, 60% of lesions were in the anastomotic area while 40% were in the venous limb. All patients had abnormal dialysis blood line pressures corresponding to the actual site of stenosis. The initial success rate of percutaneous transluminal angioplasty in treating the stenotic lesions was 73%. This method is thus a promising form of semi-invasive treatment for symptomatic arteriovenous fistula stenosis.