Search PubMed⌕ Search

Biomedical subjects

T Y Chan

Publications and source records attributed to T Y Chan.

At least 145 records · Page 8Linked to original sources
PubMed1994

Adverse reactions to intravenous N-acetylcysteine in Chinese patients with paracetamol (acetaminophen) poisoning.

The incidence of adverse reactions to intravenous N-acetylcysteine (NAC) was studied in 56 Chinese patients with paracetamol (acetaminophen) poisoning. Eight (14%) patients developed a skin rash (n = 7) or fever (n = 1) mostly during the initial high dose infusion of the antidote. In four subjects (three with toxic plasma paracetamol levels), the infusion was continued without a worsening of the adverse reaction. NAC was discontinued in the remaining four subjects in whom the paracetamol levels were subsequently found to be non-toxic. Intravenous chlorpheniramine was given to six subjects. All eight subjects completely recovered. In the dose that is recommended for the treatment of acute paracetamol poisoning, intravenous NAC is generally safe in Chinese but mild side effects are common. We recommend that the initial loading dose is given over 60 rather than 15 min.

Acetaminophen↗
PubMed1994

Poisoning due to Savlon (cetrimide) liquid.

1. Seven adult cases of deliberate oral exposure to 'Savlon' liquid (chlorhexidine gluconate 0.3%, cetrimide 3%) are presented. 2. In six patients, the symptoms were relatively mild including nausea, vomiting, sore throat and abdominal pain. 3. One patient who had concomitantly taken 'Dettol' liquid was comatose and hypotensive at presentation and was complicated by aspiration pneumonia and adult respiratory distress syndrome (ARDS). She was ventilated for a total of 10 days and was hospitalised for 5 weeks. 4. The data from this study suggest that symptoms associated with Savlon poisoning are usually mild. When aspirated, Savlon together with 'Dettol' liquid can cause ARDS.

Abdominal Pain↗
PubMed1994

Pharmacists' attitudes toward adverse drug reaction reporting in Hong Kong.

OBJECTIVE: To study the attitudes and knowledge of pharmacists in Hong Kong toward the reporting of adverse drug reactions (ADRs). METHODS: In December 1993, all pharmacists who were working in retail shops (n = 230), hospitals (n = 44), or outpatient clinics (n = 12) in Hong Kong were sent a questionnaire as well as a letter explaining the purpose of the survey. RESULTS: One hundred and twenty-nine pharmacists (retail pharmacies 40.4 percent, hospitals 68.2 percent, outpatient clinics 50 percent) responded. Although 93 percent of the pharmacists in this survey agreed that it is necessary to report ADRs, a much smaller proportion (14.7 percent) had actually done so in the previous 12 months. Most pharmacists (87.4 percent) were not aware of any ADR reporting system in Hong Kong. There did not appear to be a relationship between ADR reporting and the length or place of practice, workload, or patient contact time. Severe or unusual ADRs and ADRs to new products were perceived to be significant enough to report. CONCLUSIONS: The great majority of pharmacists in Hong Kong agreed on the necessity of reporting ADRs. The lack of knowledge of an ADR reporting program might have led to nonreporting in the past. It is important that there be continuing efforts to promote ADR reporting programs.

Adverse Drug Reaction Reporting Systems↗
PubMed1994

Adverse interaction between warfarin and indomethacin.

A 57-year-old man developed spontaneous skin bruising and haematuria during combined therapy with warfarin and indomethacin. Due to the potential effects of nonsteroidal anti-inflammatory drugs (NSAIDs) on the anticoagulant action of warfarin and platelet function, patients receiving both warfarin and NSAIDs should have their prothrombin time monitored very closely. Also, the risk of gastrointestinal haemorrhage with any NSAIDs must always be remembered.

Drug Interactions↗
PubMed1994

Factors regulating sterol biosynthesis in the rat pineal gland in vitro.

The effects of hormones, feeding and photoperiod on pineal sterol biosynthesis were studied in rat pineal glands incubated with 1-14C acetate. The rate of sterol biosynthesis was 7.1 nmol/g/2 h. A high synthesis rate was observed during mid-dark of a 12:12 LD cycle and under constant light. Melatonin, testosterone, and glucagon had no effect on sterol synthesis whereas estradiol increased it and insulin and norepinephrine treatments decreased it. Increased cAMP levels resulting from dibutyryl cAMP and theophylline were also found to be inhibitory. Dietary cholesterol did not alter the rate of sterol biosynthesis but 24 h fasting depressed sterol synthesis significantly. It can be concluded that hormones and substrate availability may be involved in the regulation of pineal sterol biosynthesis.

Animals↗
PubMed1994

The prevalence of hypercalcaemia in pulmonary and miliary tuberculosis--a longitudinal study.

We studied the prevalence of hypercalcaemia in 34 Chinese patients with pulmonary (n = 32) or miliary (n = 2) tuberculosis. None of these subjects were given vitamin D or calcium supplements. Plasma calcium levels were measured at presentation and at 1- to 2-monthly intervals after treatment. During the 6-month study period, two patients (6%) developed hypercalcaemia (plasma calcium greater than 2.51 mmol/l), as compared to figures of 16% to 28% in the United States and India. By correcting the plasma calcium to a normal albumin, five (15%) of our patients were hypercalcaemic, as compared to a figure of 48% in Greece. Apart from variations in methodology, discrepancies in the reported prevalence of hypercalcaemia in tuberculosis may be due to differences in sun exposure, and vitamin D and calcium intake.

Adolescent↗
PubMed1994

Hospital admissions due to acute poisoning in the New Territories, Hong Kong.

To study the pattern of acute poisoning in the New Territories East of Hong Kong, 291 adult cases admitted to the Prince of Wales Hospital in 1989 were reviewed. The female-to-male ratio was 2.3 to 1 and the majority of patients (83%) were below the age of 40. The main poisons involved were hypnotics and sedatives (44.3%), household products (14.8%) and analgesics (10%). The poisoning was intentional in the majority of cases (98.6%). A specific antidote was necessary in 5.2% of cases. Four patients died after admission giving an overall mortality of 1.4%. When compared to the findings from other western countries, important variations in the pattern of acute poisoning were seen in Hong Kong. Firstly, a substantial proportion of drugs ingested were not dispensed labeled although their nature could usually be determined. Secondly, "Dettol", a household antiseptic, was commonly used in self-poisoning episodes. The lack of drug identification labeling on dispensed medicines outside hospitals is of great concern to all physicians in Hong Kong.

Acute Disease↗
PubMed1994

Aconitine poisoning due to Chinese herbal medicines: a review.

Both "chuanwu", the main root of Aconitum carmichaeli, and "caowu", the root of A kusnezoffii, are believed to possess anti-inflammatory, analgesic and cardiotonic effects and have been used in Chinese materia medica mainly for the treatment of musculoskeletal disorders. They contain the highly toxic C19 diterpenoid alkaloids of aconitine, mesaconitine and hypaconitine. After ingestion, patients may present with signs and symptoms that are typical of aconitine poisoning. Death may occur from ventricular arrhythmias, which are most likely to occur within the first 24 h. Management of aconitine poisoning is essentially supportive. There are no adequate studies in humans to indicate the most effective treatment of the ventricular arrhythmias. All clinicians should be alerted to the potential toxicity of "chuanwu" and "caowu".

Aconitine↗
PubMed1994

Abnormal calcium and vitamin D metabolism in tuberculosis.

A variety of abnormalities in calcium and vitamin D metabolism have been reported in patients with active tuberculosis (TB), including hypercalcaemia, hypercalciuria and increased sensitivity to vitamin D. In this article, the frequency and nature of these abnormalities and the importance of extrarenal 1,25(OH)2D production are discussed.

Calcium↗
PubMed1994

Poisoning by Chinese herbal medicines in Hong Kong: a hospital-based study.

The harmful effects of some Chinese herbal medicines (CHM) have become a cause for concern among the medical profession and the general public in Hong Kong. From 1989 to 1993, at least 33 patients were treated in the Prince of Wales Hospital because of severe poisoning by CHM. Of these, 20 presented with clinical features typical of aconitine poisoning following the ingestion of "chuanwu", the main root of Aconitum carmichaeli, or "caowu", the root of Aconitum kusnezoffii. Strict legislation controlling the use of chuanwu and caowu alone would have prevented many of the severe poisonings by CHM in Hong Kong.

Adolescent↗
PubMed1994

Aconitine poisoning: a global perspective.

The circumstances under which poisoning by the Aconitum species or their derivatives occurred since 1950s are reviewed. Aconitine poisoning is far more common in Asia, particularly China and Hong Kong, than in the western countries. This may be because of the widespread use of herbal medicines by the Asian communities. Outside Asia, poisoning usually occurs after ingesting the wild plant of the Aconitum species. Asians may still have easy access to herbal medicines even when living in western countries.

Aconitine↗
PubMed1994

Severe hypercalcaemia associated with miliary tuberculosis.

Hypercalcaemia is uncommon among patients with pulmonary tuberculosis in Hong Kong, possibly because of the low dietary calcium intake in this population. We report here a case of severe hypercalcaemia in a patient with miliary tuberculosis and impaired renal function. We suggest that tuberculosis should be excluded in any febrile patient with hypercalcaemia, particularly in countries where it is still a common condition and an important cause of hypercalcaemia.

Adult↗
PubMed1994

The prevalence use and harmful potential of some Chinese herbal medicines in babies and children.

This article reviews the prevalence use of Chinese herbal medicines (CHM) in Chinese pregnant women, babies and children living in Hong Kong and the harmful potential of some CHM and Chinese proprietary medicines (CPM) in babies and children. The use of CHM appears to be common amongst Chinese pregnant women. The possible effects of these herbs on the fetus and baby and their overall safety are not known. This practice should be discouraged since there is suggestion that maternal consumption of CHM might increase the risk of neonatal jaundice. Both "chuen-lin" and "yin-chen" can displace bilirubin from their serum protein binding and increase the risk of hyperbilirubinaemia. These herbs should not be given to the neonates. The use of CPM-containing undeclared drugs of high toxicity or lead, arsenic and mercurial compounds should be banned. The medical profession and the general public should be alerted to the harmful potential of some of the CHM and CPM. There should be continuing efforts to collect information on the safety of these compounds.

Child↗
PubMed1994

Is chloroxylenol nephrotoxic like phenol? A study of patients with DETTOL poisoning.

Chloroxylenol, a phenolic derivative commonly used as a household disinfectant, has similar, although lesser, toxic manifestations in comparison to phenol when ingested. The main objective of this study was to determine if chloroxylenol is nephrotoxic like phenol by studying 121 patients with DETTOL (4.8% chloroxylenol, pine oil, isopropyl alcohol) poisoning. Three patients (2.5%) developed renal impairment as evidenced by raised plasma urea and creatinine concentrations following ingestion of 200 to 500 ml of DETTOL. Two of these patients also had serious complications, including aspiration leading to pneumonia and adult respiratory distress syndrome, from which 1 died. The etiology of the renal impairment is likely a direct toxic effect of chloroxylenol on the kidneys and associated transient hypotension. Fortunately, renal impairment only appears to be a problem when relatively large amounts of DETTOL are ingested.

Adolescent↗
PubMed1994

A study of calcium and vitamin D metabolism in Chinese patients with pulmonary tuberculosis.

Hypercalcaemia can occur in patients with tuberculosis. To further characterize the calcium and vitamin D metabolism in this disorder, serum calcium, 25(OH)D, 1,25(OH)2D and parathyroid hormone and the interrelationships between serum calcium, 25(OH)D and 1,25(OH)2D were compared in 24 untreated Chinese patients with culture-positive pulmonary tuberculosis and 24 age and sex-matched controls in Hong Kong. Albumin adjusted serum calcium was significantly higher in patients (2.33 +/- 0.07 compared with 2.20 +/- 0.09 mmol l-1, P < 0.001), despite a lower calcium intake (426 +/- 208 compared with 564 +/- 335 mg day-1). No significant group difference was found in serum 25(OH)D or 1,25(OH)2D concentrations. There was a positive correlation between serum 25(OH)D and 1,25(OH)2D concentrations in the patient group (r = 0.50, P < 0.02), but a negative one in the control group (r = -0.48, P < 0.05). Serum parathyroid hormone was significantly lower in patients (20.9 +/- 8.5 compared with 38.2 +/- 14.5 pmol l-1, P < 0.001). In the patient group, no correlation between the radiographic extent of disease and serum calcium or 1,25(OH)2D concentrations was seen. Our findings confirmed that serum calcium is raised in tuberculosis but the effect may be reduced by a low calcium intake and a low parathyroid hormone level. Although the calcium and vitamin D metabolism appeared to be altered in tuberculosis, no direct relationship between serum calcium and 1,25(OH)2D, was found.

Adult↗