Ice-skating is a popular sport in Hong Kong. Since the opening of our hospital, we have observed a special pattern of injury related to ice-skating. Individuals have had a wide range of injuries including fractures and deep tissue lacerations, many of which have needed operative intervention. Public awareness of the risks remains low. The pattern and mechanisms of injury, management modalities, and contributing factors to the injuries are discussed. Preventive measures and socioeconomic implications are also discussed.

Urinary incontinence is a common problem among the elderly, especially those admitted to acute care hospitals. A study investigating this problem was conduced in the geriatric wards of the Tuen Mun Hospital, Tuen Mun, from 26 October 1995 to 9 November 1995. Fifty of 139 (36%) patients had urinary incontinence with a male to female ratio of 1:15. Patients with urinary incontinence were found more often to have mobility problems and a higher institutionalisation rate than did continent patients. Dementia and cerebrovascular accident were also found to be associated with this problem. Although it is a common problem, none had been evaluated or treated before. Most of the caregivers thought that urinary incontinence was a normal ageing process and used diapers to treat this problem.

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.