Thrombocytopenia, defined as a platelet count of less than 150,000/microL, is clinically suspected when there is a history of increased bruising or bleeding, or when there is petechiae noted which is often referred to as a “rash”. Thrombocytopenia is usually asymptomatic until platelet counts fall below 50,000/microL, and may also be detected incidentally in a full blood count (FBC) during routine evaluation of an asymptomatic patient or during investigations performed for other reasons.1
Genetic diseases cause great physical effect to newborns and psychological impact to parents. Recessive genetic diseases can hit asymptomatic carrier couples with detrimental impact because very often they are not aware of their carrier status. Recessive genetic disease affects at least 30 in every 1,000 children, ranging from very mild to severe phenotype.1-2 Common examples of recessive genetic diseases include thalassaemia, spinal muscular atrophy, congenital adrenal hyperplasia, cystic ﬁbrosis, among others.
Chronic hepatitis B virus (HBV) infection is a global problem. Chronic
HBV infection is probably the most common maternal infection encountered
in Hong Kong, China, and Southeast Asia. In Hong Kong, which is one of
the endemic areas, immunisation against HBV was first provided in 1983
to infants born to mothers who were screened positive for hepatitis B
surface antigen (HBsAg). Immunisation became widespread since November
1988, but HBsAg-positive mothers are still encountered frequently.1
This review article outlines the prevalence of nausea and vomiting of pregnancy (NVP) and hyperemesis gravidarum (HG), definition of NVP and HG, aetiology, risk factors, complications of HG, recommended investigations, primary care management, hospital and ambulatory daycare, therapeutic management of HG supported by good clinical evidence, discharge planning, and importance of the multidisciplinary team to provide high quality care in patients with NVP and HG.
Uterine arteriovenous malformation (AVM) is an abnormal connection between arteries and veins within the uterus. Although AVM can be congenital or acquired, this article focuses on the diagnosis and management of acquired AVMs identified following early pregnancy complications. AVMs may develop as a result of damage to the uterine tissue following spontaneous miscarriage, pregnancy termination, dilatation and curettage, caesarean scar pregnancy, or gestational trophoblastic disease.1 The incorporation of necrotic villi in the venous sinuses of scar tissue is thought to cause acquired AVM.2
Uterine arteriovenous malformation (AVM) is an abnormal connection
between arteries and veins within the uterus. Although AVM can be
congenital or acquired, this article focuses on the diagnosis and
management of acquired AVMs identified following early pregnancy
complications. AVMs may develop as a result of damage to the uterine
tissue following spontaneous miscarriage, pregnancy termination,
dilatation and curettage, caesarean scar pregnancy, or gestational
trophoblastic disease.1 The incorporation of necrotic villi in the venous sinuses of scar tissue is thought to cause acquired AVM.2
Immunization protects children from serious, life-threatening infectious diseases. Certain reasons, for eg, missing one or more appointments or illness during the time a child should receive a shot, explain why children may not be fully immunized. The goal of this activity is to refresh doctors' knowledge on catch-cup immunization and also diphtheria, an acute, toxin-mediated bacterial infection that often strikes unimmunized children. Click here to access the module.
Advances in antenatal, perinatal, and neonatal care lead to increased survival of preterm infants. As survival rates continued to increase, so did the angst of “intact survival,” or survival without disabilities. A recent meta-analysis revealed that at school-age, cognitive scores of former very low birth weight (VLBW) infants are approximately 10 points lower than those of matched control children1 due to difficulties with attention, behaviour, visual-motor integration, and language performance.2-3
During foetal life, blood flows through the ductus arteriosus (DA) from the pulmonary artery into the aorta, thereby bypassing the lungs. After birth, the DA undergoes active vasoconstriction and eventual closure. A patent ductus arteriosus (PDA) occurs when the DA does not close completely after delivery.
The combined use of piperacillin and tazobactam does not appear to be a suitable alternative to meropenem for patients with bloodstream infections caused by ceftriaxone-resistant Escherichia coli (E. coli) or Klebsiella pneumoniae (K. pneumoniae), according to results of the MERINO* trial.
Taking oral antibiotics appears to increase the risk of nephrolithiasis, according to a recent study. Moreover, the risk seems to be compounded for individuals with recent antibiotic exposure and those who were exposed at a younger age.
Male smokers under the age of 50 years are at risk of developing ischaemic stroke, and this risk increases with the number of cigarettes smoked daily, according to data from the Stroke Prevention in Young Men Study.
Early renin-angiotensin-aldosterone system (RAAS) blockade with renin-angiotensin system inhibitors (RASI) leads to better short- and long-term renal outcomes in systemic lupus erythematosus (SLE) patients with antiphospholipid-associated nephropathy (aPLN), according to a study, adding that this renal protective effect is independent of RASI’s antihypertensive and antiproteinuric effects.