Epiretinal membrane is a common surgical disease of the elderly. The aetiology, clinical presentation, and diagnosis are briefly described. Management, principally vitrectomy and membrane removal, is then elaborated. Recent advances such as internal limiting membrane peeling are further discussed. The safety and efficacy of intra-ocular dyes, including indocyanine green and trypan blue, as well as the new technique of ‘double staining’, are evaluated.

From 1 August 2001 to 31 July 2004, 137 patients were referred from the Association Concerning Sexual Violence Against Women to the Accident and Emergency Department at the Kwong Wah Hospital for alleged rape. Approximately half of the patients presented within 3 days of the alleged assault. Fifty-one patients were prescribed emergency contraception: one patient remained pregnant despite treatment and was referred with a further six patients to the Gynaecology Department for termination of pregnancy. Thirty-two patients received hepatitis B immunoglobulin injection. One patient had a positive result for rapid plasma reagin 3 months following the assault and was referred to the Social Hygiene Clinic. All tests for antibody to human immunodeficiency virus were negative. Antimicrobial therapy was prescribed for women who had an endocervical and/or high vaginal swab positive for Chlamydia trachomatis (n=9), Trichomonas vaginalis (n=1), and gonococcus (n=1).

A territory-wide cervical screening programme was launched in Hong Kong in March 2004. Since 2002, 160 nurses from the Department of Health’s Maternal and Child Health Centres have completed the training necessary to carry out the screening procedures. A clinical audit of their performance was carried out between 2002 and 2004. A customer satisfaction survey revealed that 94% of respondents agreed or strongly agreed that they were satisfied with the cervical smear procedure performed by nurses. Since January 2003, all routine cervical screening tests at Maternal and Child Health Centres have been performed by nurses. The mean time required to complete a test is 7 minutes. The mean unsatisfactory smear rate for the year 2003 was 1.3%, well below the benchmark of 5% set by the Working Party on Quality Assurance of the Cervical Screening Task Force. The results of this survey confirm that nurses at Maternal and Child Health Centres are highly effective and efficient at taking smears and that this is well accepted by clients.

Halitosis refers to the condition of offensive mouth odour. More than 90% of cases of halitosis originate from the oral cavity. The implicated bacteria (Fusobacterium nucleatum, Prevotella intermedia, and Tannerella forsythensis) are located in stagnant areas in the oral cavity, such as the dorsal surface of tongue, periodontal pockets, and interproximal areas. These bacteria proteolyse the amino acids releasing volatile sulphur compounds. The management of halitosis involves determining and eliminating the causes, which includes identifying any contributory factors, because certain medical conditions are also associated with characteristic smells. Professional advice should be given on oral hygiene and diet, and treatments should include dental scaling, and root planing of the associated periodontal pockets to reduce the bacterial loading. In addition to the normal oral hygiene practice, tongue cleaning and use of mouthwash are advocated. This paper discusses the common aetiological factors, classification of oral halitosis, and its treatment.

Osteoporosis is associated with thinning of cortical and trabecular bone, which reduces bone strength and predisposes individuals to fracture development. Femoral neck fractures in patients with osteoporosis may not be apparent on radiographs. Magnetic resonance imaging is useful at detecting these radiographically occult fractures; yet, the practice has not been widely adopted in Hong Kong. In this article, we review our experience of early magnetic resonance imaging in this clinical context—that is, imaging performed within 48 hours of presentation to hospital. Twenty-eight patients (age range, 69-93 years) over a 3-year period were studied. Magnetic resonance imaging revealed radiographically occult neck fractures in 14 (50%) cases (equivalent to 4% of all femoral neck fractures). These fractures were treated surgically (64%) or conservatively (36%) with good bone healing and clinical outcome. When no femoral neck fracture was present, magnetic resonance imaging revealed an alternative cause for symptoms in all 14 cases. We strongly endorse the use of early magnetic resonance imaging for patients with osteoporosis who have a clinically suspected femoral neck fracture that is not visible radiographically.