Stroke Prevention and Management
Stroke is a leading cause of death
worldwide and the commonest cause
of permanent disability in adults.
The death and disability from
stroke is expected to increase in Hong Kong as the population rapidly ages in coming decades. This article highlights the need to reduce the local burden of stroke through the screening of individuals for stroke risk management and through ensuring a prompt and effective treatment response after stroke onset.
Common Presentations in the Head & Neck
Lumps in the head and neck are
common and the cause is usually
benign. There are numerous causes
of head and neck masses.
Nevertheless these may be the presentation of either a malignancy or a chronic infection. If these abnormal structures persist for more than two weeks and there is doubt as to the cause, then the patient should be referred for specialist assessment.
Sacroiliac Joint Pain FAQs
Sacroiliac (SI) joint pain is a
challenging condition affecting 15%
to 25% of patients with axial low
back pain, for which there is no
standard long-term treatment. Recent studies have demonstrated that historical and physical examination findings and radiological imaging are insufficient to diagnose SI joint pain. The most commonly used method to diagnose the SI joint as a pain generator is with small volume local anaesthetic blocks. In the article, I will try to explain the diagnostic methods and available treatments in detail.
Highlights from 2014 American Heart Association & European Society of Cardiology in the Management of Coronary Heart Disease and Percutaneous Coronary Intervention - for the Primary Care Physician
Cardiovascular diseases remain the
number one cause of death globally,
mainly due to Coronary Heart
Disease (CHD) and Stroke . An
estimated 17.3 million people died from cardiovascular diseases in 2008, representing 30% of all global deaths.
The 2014 meetings of the American Heart Association & European Society of Cardiology in the Management of Coronary Heart Disease and Percutaneous Coronary Intervention made updates.
Meniscus FAQs: Tears, Repairs & Transplants
The menisci are two rubbery
crescent moon shaped flat pieces of
cartilage in each knee. The main
purpose of the meniscus is to act
like a washer – spreading load on the articular cartilage. Because the menisci are subjected to huge forces in everyday life, the menisci can tear simply standing up from sitting or climbing a step. Before arthroscopic surgery was developed in the 1970s, the only treatment for a meniscus tear was to remove the meniscus, which will eventually develop arthritis. Now, depend on the severity, a torn meniscus can be repaired, trimmed, or replaced.
Stomach Ulcers & Related Conditions FAQs
Indigestion is a common symptom for
city dwellers, and is usually
caused by either gastritis or
ulcers. Gastritis refers to
inflammation of the lining of the stomach and could lead to ulcers if left untreated. There are many causes for gastritis or ulcers: a bacterium called Helicobacter pylori (H. pylori); certain aspirin or aspirin containing drugs; smoking; alcohol; excessive stomach acid; irregular eating habits; stress, etc. The best way to diagnose these conditions is by gastroscopy, which uses a thin flexible tube with a micro-camera attached to its tip, which displays images on a monitor in real time.
'Slipped Disc' FAQs
‘Slipped disc’ is a colloquial
term for a burst (or prolapse or
herniation) of the intervertebral
disc. This is much like a jam
doughnut bursting and the jam coming out. From early adulthood, the annulus fibrosus becomes weaker. As a result, the intervertebral disc is more vulnerable to the pressure of the body’s weight. If the annulus fibrosus tears, the jelly like nucleus pulposus leaks out to become a herniated disc.
Treatment of Cervical Disc Hernia or Degeneration
Cervical disc hernia with spinal
cord or nerve root compression is a
common disease. It is common
younger population including those
without special risk factors. Surgical treatment has good outcomes if conservative treatment fails. The surgical risk is not high. There are newer technology to overcome the problem of the past in reducing the surgical risk and speeding recovery. First line treatment for most cervical disc problems is pain control and physical therapies. Second line treatment includes injections and radiofrequency neurotomy. If this approach fails, or if there is significant neurological deficit, surgical treatment is appropriate.
Hamstring Tendon Tears FAQs
This provides information to
patients on 'high' hamstring tendon
‘tears’ or ‘bone
avulsions’, but not
‘tendinitis’ or ‘tendinopathy’. A ‘tear’ in this context usually means the tendon tears away from the bone. Sometimes the tendon pulls a piece of bone away, instead of tearing away from the bone, and this is called a ‘bone avulsion’. The ‘Hamstring Tendinopathy FAQs’ describe ‘tendinitis’, which is usually treated differently.
Interventional Pain Management
Pain is a multidimensional
experience. Chronic pain differs
from acute pain in that it lasts
for more than 3-6 months, and there
may not be obvious tissue injury leading to the pain. The pathway leading from stimulus to perception may be sensitised. There is often associated depression. Management of chronic pain therefore requires a holistic multi-disciplinary approach. In addition to pharmacological treatment, psychosocial support, physiotherapy and operative treatment, interventional techniques may benefit some patients by defining the pain generator and offers prolonged relief.