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Chan Y.C.,Hong Kong Poison Information Center
Hong Kong Journal of Emergency Medicine | Year: 2014

Objective: To report and analyse the poisoning data of Hong Kong Poison Information Centre (HKPIC) in 2013. Methods: In 2013, all poisoning cases received by HKPIC were retrieved from its database [Poison Information and Clinical Management System (PICMS)] for analysis. Results: A total of 3,783 poisoned cases were analysed. There were 1,595 male patients (42.2%), 2,185 female patients (57.8%) and 3 sex unspecified patients (0.1%). Middle aged group (30-39 years) composed about one-fifth (20.8%) of the poisoning cases while about two-third (66.8%) of them were between 20 and 59 years old. Common causes for poisoning were suspected self-harm/suicidal attempt (43%), unintentional exposure (15.3%) and abusive substances use (14.5%). Five commonest types of poison exposed were paracetamol, benzodiazepine, zopiclone, household products and Chinese herbal medicine. Majority of the patients were managed with supportive measures, and 13.2% and 10.8% of them were treated by decontamination and antidotes respectively. Most cases had uneventful recovery; 0.9% of the poisoning resulted in death and 4.3% had major outcomes. Conclusions: This 8th annual report provided updated epidemiological information on poisoning pattern in Hong Kong and highlighted important changes in comparing with our previous reports. Source


Chan Y.C.,Hong Kong Poison Information Center
Hong Kong Journal of Emergency Medicine | Year: 2013

Objective: To report and analyze the poisoning data of Hong Kong Poison Information Centre (HKPIC) in 2012. Methods: In 2012, all poisoning cases received by HKPIC were retrieved from its database: Poison Information and Clinical Management System (PICMS) for analysis. Results: A total of 4,814 poisoned cases were analyzed. There were 1,771 male patients (42.3%), 2,399 female patients (57.3%) and 14 sex unspecified patients (0.3%). Middle aged group (30-39 years) contributed about one-fifth (20.1%) of the poisoning cases while more than two-third (67.7%) of them were between 20 and 59 years old. Common causes for poisoning were suspected self-harm/suicidal attempt (45%), abusive substances use (13.9%) and unintentional exposure (13.0%). Five commonest types of poison exposed were paracetamol, benzodiazepine, zopiclone, bites and envenomation and household products. Majority of the patients were managed with supportive measures, and 15.7% and 11.9% of them were treated by decontamination and antidotes respectively. Most cases had uneventful recovery; 0.6% of the poison exposure resulted in death and 4.7% of the exposure had major outcomes. Conclusions: This seventh annual report provides updated epidemiological information on poisoning pattern in Hong Kong and highlights important changes in comparing with our previous reports. Source


Chow A.T.Y.,Hong Kong Poison Information Center
Hong Kong Journal of Emergency Medicine | Year: 2015

Spot urine tests are commonly employed by emergency physicians in Hong Kong to detect recent abusive drug exposure. Spot tests utilising oral fluid are gaining its popularity in other parts of the world. There was lack of evidence about employment of rapid oral fluid test (ROFT) in the local emergency medical settings. The objective of this study is to determine the operating characteristics of ROFT, and to compare its agreement with the bedside urine immunoassay test (BUIT). Setting: The emergency department and the substance abuse clinic of a regional hospital. Methods: This was a single-centered cross-sectional study of diagnostic test. Patients suspected to have drug abuse were tested using either one or both of the commercially available ROFT and BUIT. The sensitivity, specificity and accuracy of both tests were calculated with reference to the laboratory urine toxicology screening results. The agreement between ROFT and BUIT was calculated. Results: For the detection of ketamine and methamphetamine (the two most prevalent abusive substances), ROFT had 72-100% sensitivity and 93-100% specificity, which were comparable to that of BUIT (74-100% sensitivity and 100% specificity). The overall observed agreement of ROFT and BUIT results was at least 96%. There was good agreement between ROFT and BUIT with kappa values of 0.90-1.00. Conclusion: In this pilot study, the operating characteristics of ROFT are comparable with that of BUIT, with both tests showing good agreements in the detection of ketamine and methamphetamine uses. ROFT can potentially be employed as an alternative investigation for rapid diagnosis of patients with suspected drug abuse. © 2015, Medcom Limited. All rights reserved. Source


Yiu-Cheung C.,Hong Kong Poison Information Center
Journal of Medical Toxicology | Year: 2012

Ketamine has been the commonest abusive substance used by Hong Kong teenager since 2005. It is also the fourth commonest poison encountered in Hong Kong Poison Information Centre (HKPIC) poisoning data in 2010. From June 2008 to July 2011, HKPIC managed 188 and 96 cases of acute and chronic ketamine poisoning, respectively, which reflect its acute and chronic toxicity pattern. Demographically, there is a male predominance, and the majority is between the ages of 10-39. For the acute cases, 48 % presented with neurological features such as confusion, drowsiness, or transient loss of consciousness which usually subside with supportive care in a few hours. For the chronic cases, 92 % of them presented with features of ketamine cystitis while about 66 % presented with chronic abdominal pain. The current understanding of ketamine cystitis and chronic abdominal pain will be reviewed. Management is primarily symptomatic measures and most importantly abstinence from ketamine use. © 2012 American College of Medical Toxicology. Source


Pang C.T.,Hong Kong Poison Information Center
Hong Kong Journal of Emergency Medicine | Year: 2010

Objective: To study the local epidemiology and clinical presentation after ingestion of oral mucosal irritating plants. Methodology: Cases presenting with immediate oral mucosal irritation after plant product ingestion from July 2005 to June 2009 were retrieved from the Hong Kong Poison Information Centre's clinical database. Their clinical features and management were reviewed. Results: Thirty cases were retrieved and analysed, including 14 males and 16 females. Poisoning occurred all year round with no seasonal predilection. Vomiting and dysphagia were the two most common symptoms other than immediate oral mucosal irritation. Half of the cases could be managed with symptomatic treatment and discharged after a few hours of observation. Six patients presented with angioedema and were managed initially with the use of intravenous steroid, antihistamine and with or without adrenaline. Urgent airway assessment with laryngoscope was performed in 3 patients. No patient required endotracheal intubation. Conclusion: Oral mucosal irritating plant ingestion is not uncommon in Hong Kong. Its clinical feature can mimic angioedema on presentation. Immediate and localized oral mucosal symptoms after plant product ingestion are the key to diagnosis. Source

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