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Biomedical subjects

K N Sin Fai Lam

Publications and source records attributed to K N Sin Fai Lam.

9 recordsLinked to original sources
PubMed2004

Endobronchial tuberculosis simulating bronchial asthma.

Pulmonary tuberculosis is still a major health problem worldwide, but the principles of diagnosis and treatment are well-established. Endobronchial tuberculosis (EBTB) is known to complicate pulmonary tuberculosis and its importance lies in the potential for bronchostenosis. In the absence of parenchymal disease, EBTB is less well-recognised and can lead to difficulties in diagnosis. We report a 26-year-old woman who presented with symptoms of cough, shortness of breath and wheezing simulating bronchial asthma. Although the chest radiograph did not show any lung infiltrate, a bronchoscopy was carried out. The findings, suspicious of malignancy, were actually due to EBTB, which was confirmed on histology by special stains and on culture for Mycobacterium tuberculosis. The patient subsequently developed bronchostenosis, a well-described complication.

Adult↗
PubMed2000

Hypertension in the young adult--come feel the pulse.

Hypertension occurring in teenagers and young adults is uncommon. Though the most common form is still essential hypertension, secondary causes are more commonly found here than in older adults. Renal, cardiovascular and endocrine diseases constitute most of these causes. Coarctation of the aorta is the most common cardiovascular cause of hypertension, and its importance lies in the fact that it is correctable, and that its persistence often leads to dangerous complications and early death. The cardinal sign of differential pulse and blood pressures between the upper and lower limbs can be detected clinically. Hence, the importance of a detailed physical examination in all young hypertensives, including palpation of all the pulses, cannot be overemphasized. We present 2 hypertensive young men who were found to have isolated coarctation of the aorta. The lesion in the first patient was located postductally just distal to the left subclavian artery. This area has been found to be the most common site of coarctation. The second patient had an unusual mid-thoracic coarctation. The clinical and radiological features as well as complications are highlighted. In young hypertensive patients, a high index of suspicion may enable the physician to make a timely diagnosis and hence avert the potentially disastrous complications that may arise in undetected cases.

Adolescent↗
PubMed1996

A profile of acute asthma patients presenting to the emergency room.

We conducted a three-month prospective study on the profile of 70 acute adult asthmatic patients presenting to the Accident and Emergency Unit of a general hospital. The overall background asthmatic activity, clinical features of current exacerbation, maintenance drug treatment, gross psycho-social problems, previous experience of near-fatal asthma, and admission and relapse rates were documented. Ninety percent of the presentations were within 24 hours of the initial attack, with an average pre-hospital therapy duration of 6.5 hours. Sixty-seven percent sought further treatment after failure to find relief from their salbutamol metered-dose inhalers. Sixteen percent did not receive any treatment before presentation. Ten percent gave a past history of mechanical ventilation for severe or near fatal asthma. The majority (94%) had asthmatic symptoms in the mild to moderate range. About half (46%) had attended the Emergency Room (ER) at least once in the previous six months. On average, patients were on two items of drugs and 23% were on maintenance inhaled steroids. One-third (33%) of the patients were found to have psycho-social problems relating to their condition. The admission rate was 37% with relapse rate following ER discharge of 13%. The study showed a high proportion of patients with psycho-social problems relating to asthma, and a subset of patients with frequent visits to the ER. It also revealed the infrequent use of prophylactic therapy.

Acute Disease↗
PubMed1996

Mortality of patients while on treatment for active tuberculosis.

In the era of effective antituberculous chemotherapy, some patients with tuberculosis still die while on treatment. The aim of this study was to review deaths occurring in patients while on treatment for active tuberculosis in Alexandra Hospital during the 4-year period from 1991 to 1994. Medical records of 30 such patients were reviewed retrospectively. Twenty-one patients were certified as dying from tuberculosis; in the remaining 9 patients, the principal cause of death was other than tuberculosis. Of the patients who died of tuberculosis, 7 (33.3%) died within a week and 19 (90.5%) died within a month of initiation of antituberculous treatment. Seventeen (81%) were males and 15 (71%) were smokers. All the 21 patients had pulmonary involvement and in 4 patients, there was disseminated disease. Chest roentgenographic findings of bilateral involvement were seen in 16 (76.2%) patients and of cavitary disease in 15 (71.4%) patients. Eighteen (86%) had a positive sputum smear result. Seven patients received corticosteroid cover. In 14 patients who had their weights recorded at initiation of antituberculous treatment, the mean weight was 36.3 kg (range 25.5k g-47k g). Notable biochemical derangements included hyponatraemia (86%) and hypoalbuminaemia (95%). Plasma cortisol and/or Synacthen stimulation test were performed in 4 patients; none was indicative of adrenal hypofunction. We conclude that death attributed to tuberculosis in patients while on treatment occurs early and is largely due to advanced disease.

Adult↗
PubMed1996

Cervicofacial actinomycosis with paravertebral spread: a case report.

We report a case of cervicofacial actinomycosis with paravertebral extension in a 60-year-old man who presented with recurrent neck masses. Diagnosis was confirmed on culture and histology of pus and debris obtained from surgical drainage. He improved only after lengthy in-hospital high dose penicillin therapy. He is currently well and is on maintenance doxycycline therapy for 6 months following the high dose penicillin therapy.

Abscess↗
PubMed1995

Massive pleural effusion in pancreatitis: 2 case reports.

We report 2 patients with left-sided pleural effusion occurring in the setting of acute pancreatitis. Both patients had a strong history of alcohol consumption. In each case the pleural fluid amylase was markedly elevated, higher than that in the serum. The effusions resolved with closed chest tube drainage and the pancreatitis subsided with conservative therapy. In patients presenting with significant pleural effusions and acute upper abdominal symptoms, a thoracentesis with determination of the amylase titre may provide a quick means of diagnosing acute pancreatitis.

Acute Disease↗
PubMed1993

Pasteurella multocida septicaemia following a dog bite.

Bite wounds are often mistakenly considered innocuous. However, they are frequently complicated by infection which may be serious. We describe a case of Pasteurella multocida septicaemia with myopericarditis following a dog bite. Treatment of the infection as well as active support of myocardial function led to a successful outcome.

Adult↗