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www.hkma.org January 2021
HK$ 100
B U L L E T I N
持 續 醫 學 進 修 專 訊
Infertility
Dr. CHUNG Hoi Sze, Cathy
CME
LIVE
HKMA CME Bulletin CME Bulletin & Online Editorial Board
持續醫學進修專訊 Co-editor
Dr. CHENG Chi Man 鄭志文醫生
Dr. HO Hung Kwong, Duncan 何鴻光醫生
Dr. LAM Ho 林賀醫生
Contents
Dr. MAK Siu King 麥肇敬醫生
Dr. WONG Bun Lap, Bernard 黃品立醫生
Editorial 2 Cardiology
Dr. CHAN Kit 陳杰醫生
Neurology
Dr. FONG Chung Yan, Gardian 方頌恩醫生
Dr. CHEN Wai Hong 陳偉康醫生 Dr. TSANG Kin Lun, Alan 曾建倫醫生
Spotlight 3 Dr. LEE Pui Yin
Dr. LI Siu Lung, Steven
李沛然醫生
李少隆醫生 Neurosurgery
譚礎璋醫生 陳秉漢醫生
Infertility Dr. TAM Chor Cheung
Dr. WONG Shou Pang, Alexander 王壽鵬醫生
Dr. CHAN Ping Hon, Johnny
Obstetrics and Gynaecology
Cardiology 7 Cardiothoracic Surgery
Dr. CHENG Lik Cheung 鄭力翔醫生
Dr. CHAN Kit Sheung 陳潔霜醫生
Dr. CHIU Shui Wah, Clement 趙瑞華醫生 Ophthalmology
A Patient Presenting with Dr. CHUI Wing Hung 崔永雄醫生 Dr. LIANG Chan Chung, Benedict 梁展聰醫生
Palpitation annd Dizzieness Dr. LEUNG Siu Man, John 梁兆文醫生 Dr. PONG Chiu Fai, Jeffrey 龐朝輝醫生
Colorectal Surgery Orthopaedics and Traumatology
Dermatology 11 Dr. CHAN Cheung Wah 陳長華醫生 Dr. IP Wing Yuk, Josephine 葉永玉醫生
Dr. LEE Yee Man 李綺雯醫生 Dr. KONG Kam Fu 江金富醫生
A Lady With Itchy Skin Rash Dr. TSE Tak Yin, Cyrus 謝得言醫生 Dr. POON Tak Lun
Dr. TANG Yiu Kai
潘德鄰醫生
鄧耀楷醫生
On Her Legs Dermatology
Dr. CHAN Hau Ngai, Kingsley 陳厚毅醫生 Paediatrics
Answer Sheet 12 Dr. HAU Kwun Cheung 侯鈞翔醫生 Dr. CHAN Yee Shing, Alvin
Dr. TSE Hung Hing, JP
陳以誠醫生
謝鴻興醫生
Endocrinology Dr. YEUNG Chiu Fat, Henry 楊超發醫生
CME Notifications 13 Dr. LEE Ka Kui 李家駒醫生
Dr. LO Kwok Wing, Matthew 盧國榮醫生 Plastic Surgery
Meeting Highlights 16 ENT
Dr. NG Wai Man, Raymond 吳偉民醫生
CME Calendar 17 Dr. CHOW Chun Kuen 周振權醫生 Psychiatry
Dr. LAI Tai Sum, Tony 黎大森醫生
Family Medicine Dr. LEUNG Wai Ching 梁偉正醫生
Dr. LAM King Hei, Stanley 林敬熹醫生 Dr. WONG Yee Him, John 黃以謙醫生
Dr. LI Kwok Tung, Donald, SBS, JP 李國棟醫生
Radiology
Gastroenterology Dr. CHAN Ka Fat, John 陳家發醫生
Dr. NG Fook Hong 吳福康醫生 Dr. CHAN Yip Fai, Ivan 陳業輝醫生
General Practice Respiratory Medicine
Dr. YAM Chun Yin 任俊彥醫生 Dr. LEUNG Chi Chiu 梁子超醫生
Dr. WONG Ka Chun 黃家進醫生
General Surgery Dr. WONG King Ying 黃琼英醫生
Dr. LAM Tzit Yuen, David 林哲玄醫生 Dr. YUNG Wai Ming, Miranda 容慧明醫生
Dr. LEUNG Ka Lau 梁家騮醫生
Rheumatology
Geriatric Medicine Dr. CHAN Tak Hin 陳德顯醫生
Dr. KONG Ming Hei, Bernard 江明熙醫生 Dr. CHEUNG Tak Cheong 張德昌醫生
Dr. SHEA Tat Ming, Paul 佘達明醫生
Urology
Haematology Dr. CHEUNG Man Chiu 張文釗醫生
The Hong Kong Medical Association is dedicated to Dr. AU Wing Yan 區永仁醫生 Dr. KWOK Ka Ki 郭家麒醫生
providing a coordinated CME programme for all members Dr. MAK Yiu Kwong, Vincent 麥耀光醫生 Dr. KWOK Tin Fook 郭天福醫生
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Association are welcome to join us. You may contact the Miss Irene GOT 葛樂詩小姐
HKMA Secretariat for details of the programme. Nephrology Miss Ivy IP 葉珈甄小姐
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MONTHLY SELF-STUDY SERIES to help you grow! Dr. LAM Man Fai 林萬斐醫生
Please read the articles and answer the questions. Dr. LEE Hoi Kan, Achillers 李海根醫生
Participants in the HKMA CME Programme will
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EDITORIAL
Hong Kong has experienced a modified lock down or more appropriate “curfew” in the last one
year and all of us must have suffered from some form of anti-epidemic fatigue. However, we have
to stay optimistic and keep ourselves physically and psychologically sound in order to fight the
virus.
For couples staying home last year without getting pregnant, the spotlight article by Dr. Cathy
CHUNG is definitely the most appropriate one! Itchy legs in this particularly cold winter will be
taken care in the Dermatology series.
Apart from studying the articles in this Bulletin, we have to stay alert about the updates on the
epidemic, active in participating in the screening & vaccination programs. Anyway, cheer up our
Hongkongers!
Dr. HO Hung Kwong, Duncan
Co-editor, Hong Kong Medical Association CME Bulletin
Subscription
Available
HKMA members are entitled to a FREE copy of CME Bulletin.
Subscription is opended to sponsors and interested individuals.
Spotlight
Infertility Dr. CHUNG Hoi Sze, Cathy
MBChB (CUHK), FRCOG, FHKCOG,
FHKAM (O&G), Cert RCOG (Reprod Med),
Dip Med (CUHK), PGDipClinDerm (QMUL)
Introduction Specialist in O&G
Associate Professor of Practice in
Reproductive Medicine, Department of O&G,
In general, over 80% couple would get pregnant after 1 year of The Chinese University of Hong Kong
regular unprotected sexual intercourse while the remaining half
(make up to 90-93% in total) would be successful after total 2 sperm concentration, sperm motility and morphology can
years of trying [1]. Infertility is defined as failure to conceive be examined. WHO 2010 criteria [2] is currently used as a
after 1 year of regular unprotected coitus. Around 1 in 6 reference value for comparison (table 1).
couples suffer from this problem worldwide.
Semen parameters WHO 2010 reference range
Causes Ejaculate volume >/= 1.5ml
Sperm concentration >/= 15 million/ml
In achieving a pregnancy, five important components are Total sperm count in ejaculate >/= 39 million
required. They include: normal sperm, normal egg, normal Total motility (progressive and >/= 40%
fallopian tube for fertilization (egg and sperm) to take place, non-progressive)
normal uterine cavity for embryo to implant and last but Normal morphology >/= 4%
not least, normal sexual intercourse resulting in successful Table 1. WHO 2010 criteria
intravaginal ejaculation. Any abnormality in these 5 factors will
reduce the chance of natural conception and may end up with Female factors
infertility. Broadly speaking, causes of infertility can be divided
into male and female factors. Nevertheless, around 20-25% Sexual dysfunction
cases can also be unexplained, that is, no abnormality can be
found after basic investigations including semen analysis test, Vaginismus, referring to spasm of vaginal muscle
ovulation test and tubal patency test. during vaginal penetration such as sexual intercourse or
gynaecological vaginal examination, will also result in coital
Male factors problem and failure in intravaginal ejaculation. By referring
to psychosexual therapist after excluding any underlying
Sexual dysfunction structural abnormality / pathology, patients can learn the
relevant relaxation skill and vaginal dilatation technique using
Sexual dysfunction, such as erectile dysfunction and different size vaginal dilators, which could be very effective.
ejaculatory problem, will lead to failure of intravaginal
ejaculation. Seeking expert advice from urologist or in case Anovulation
of suspecting any underlying medical disorders like diabetes,
referral to physician is indicated. In some cases, men may Women with ovulation problem will mostly present with
only have problem during sexual intercourse but no problem in irregular menstrual cycle or even amenorrhoea, although 5%
ejaculation by masturbation or in producing semen sample for women with regular monthly cycle may also have anovulation.
semen analysis test. In this scenario, psychological component Diseases involving any part along the hypothalamic-
needed to be considered and referral to psychosexual pituitary-ovarian axis will affect normal ovarian function
therapist would be helpful. and hence ovulation. For example, excessive weight loss,
hyperprolactinaemia and thyroid disease will affect normal
Abnormal semen parameters hormonal secretion (GnRH/FSH/LH) from hypothalamus
and pituitary gland. Therefore, ovary cannot be stimulated
Depending on the severity of appropriately to have ovulation. On the other hand, women
abnormality, it could be due to various who had previous ovarian surgery, chemotherapy or pelvic
pathologies like testicular problems radiotherapy, they are at particular high risk of ovarian
such as testicular failure or varicocele, failure. This will lead to not only anovulation, but also early
genetic / chromosomal abnormality, or premature menopause. In addition, polycystic ovarian
hypothalamic / pituitary disease syndrome (PCOS) is a common cause of anovulation. It is due
or mo s t ly com m onl y , i d i o p a t h i c . to the disorder of gonadotrophin action and hence ovulation
By performing semen analysis cannot be achieved. Women with PCOS may also have clinical
test, numerous semen parameters hyperandrogenism such as acne or hirsutism and they are at
including ejaculate semen volume, risk of developing metabolic diseases.
www.hkma.org HKMA CME Bulletin 持續醫學進修專訊 January 2021 3
Spotlight
Tubo-peritoneal problem be asked for any history of pelvic surgery, sexually transmitted
disease, ectopic pregnancy, duration of infertility and any
Fertilization is one of the important steps in achieving dysmenorrhea/dyspareunia or history of endometriosis. If
pregnancy. Women who had history of ectopic pregnancy, patient has positive answer for one of the above, she is
pelvic surgery, pelvic inflammatory disease or sexually considered to be at high risk and this will affect the option
transmitted disease, they are at risk of having peri-tubal of subsequent tubal assessment. In addition, woman will be
adhesion and tubal blockage. This will increase their chance asked if she has any intermenstrual bleeding or menorrhagia
of having ectopic pregnancy and infertility. For those with that may be related to underlying uterine pathology like
endometriosis who may present with dysmenorrhea or endometrial polyp or fibroid. If patient has scanty menstrual
dyspareunia, the ectopic pelvic endometrial tissue will also flow and history of uterine surgery, intrauterine adhesion
affect the normal tubo-peritoneal environment and reduce the needed to be suspected.
chance of in-vivo fertilization.
For male partner, specific questions regarding smoking and
Uterine factor drinking habit, any history of genital tract trauma, infection and
surgery needed to be asked.
Embryo implantation is the final step involved in conception
and a normal uterine cavity is a pre-requisite. Women who Physical examination
have endometrial polyps and fibroids protruding into uterine
cavity (mainly submucosal fibroid) may have reduced chance Most of investigations will be done on female partner.
of pregnancy due to the distortion of uterine cavity for Speculum examination will be performed and endocervical
implantation. With previous uterine surgery, especially uterine swab (or urine) will be taken to check for any chlamydial
curettage involving in surgical termination of pregnancy or infection. Pelvic ultrasound is used to look for any underlying
surgical management of miscarriage, women are at risk uterine (endometrial polyp / fibroid) or ovarian (polycystic ovary
of having intrauterine adhesion and they may present with / endometrioma) pathology.
reduced or scanty menstrual flow after the surgery. This
adhesion or scarring will adversely affect the endometrium Investigations
causing failure of embryo implantation. Some patients with
history of tuberculosis endometritis will also be at risk of Endocervical swab (or urine): check for chlamydial infection
developing intrauterine adhesion.
Blood tests:
Management Q CBC to screen for any thalassemia trait and Rubella
antibody IgG test to check woman’s immunity status +/-
History for vaccination.
Couple is preferably to be seen together and then interviewed Q For ovulation and ovarian function tests, FSH (Follicle
separately regarding those sensitive issues such as history stimulating hormone), LH (Luteinizing hormone), E2
of previous pregnancy and sexually transmitted disease. (Estrogen) will be checked during early follicular phase
The frequency of sexual intercourse and whether successful (Day 2 to 5 of menses) and Progesterone level will be
intravaginal ejaculation can be achieved will be checked with check during mid luteal phase (7 days before the first day
couple in order to screen for any underlying coital problem. of next period) for women with regular menstrual cycle.
Besides, any significant medical history and family history of
genetic disease from couple is also important. Q If anovulation is suspected, additional blood tests
including prolactin, thyroid function test and female
For female partner, questions regarding length of menstrual androgen profile are indicated in order to screen for any
cycle and regularity will be asked in order to screen for any underlying endocrine diseases.
ovulation problem. If patient had irregular cycle or even
amenorrhoea, specific questions relating to any underlying S e m e n a n a l y s i s : M e n n e e d t o h a v e 2-7 d a y s s e x u a l
endocrine diseases such as any acne or hirsutism (PCOS), any abstinence before the test. Besides, semen sample needed
galactorrhoea, visual field defect or taking antipsychotic drug to be collected by masturbation and delivered to laboratory
(hyperprolactinaemia), any significant weight loss or excessive for testing within 1 hour while keeping at room temperature
exercise (hypothalamic cause) and also any previous ovarian during delivery. If the first result is abnormal, second sample
surgery, chemotherapy or menopausal symptoms (ovarian will be checked 3 months later in order to confirm whether the
failure) will be checked with her. In order to screen whether abnormality is persistent.
woman is at risk of having tubo-peritoneal diseases, she will
4 HKMA CME Bulletin 持續醫學進修專訊 January 2021 www.hkma.org
Spotlight
Tubal patency tests Management options
Q Hysterosalpingogram HSG: This is a screening test and Healthy lifestyle: Couple should be advised to have healthy
is only suitable for women at low risk for tubo-peritoneal lifestyle such as balanced diet, regular exercise, weight
disease. It is an outpatient procedure performing by reduction if obese and smoking cessation. Women should take
radiologist and no anaesthesia is required. folic acid while she is planning for pregnancy in order to reduce
the chance of fetus having neural tube defect.
Expertise referral: Couple should be referred to relevant
experts if in case of any underlying psychosexual, urological or
endocrine pathology is suspected.
Operation: Surgery is one of the options for managing
tubo-peritoneal cause of infertility and it is the mainstay
of treatment for uterine pathology. Laparoscopic tubal
surgeries such as salpingostomy (for distal tubal blockage)
and hysteroscopic proximal tubal cannulation (for proximal
tubal blockage) could be performed if in case of mild tubal
Q Laparoscopy and chromotubation: This is a gold disease. However, surgery is not effective in moderate to
standard test for proper tubo-peritoneal assessment and severe tubal problems and chance of future ectopic pregnancy
is indicated for high risk women. Therapeutic surgeries also needs to be considered. For pelvic endometriosis and
including adhesiolysis and tubal surgery can be done at adhesion, laparoscopic ablation / excision of endometriosis
the same time. However, it requires general anaesthesia and adhesiolysis can also be performed at the same time.
and laparoscopy. Laparoscopic ovarian drilling could be done for patient
with PCOS if she needs to undergo laparoscopy and
chromotubation as part of her tubo-peritoneal assessment. For
managing intrauterine pathologies, hysteroscopic surgeries
such as resection of fibroids, endometrial polypectomy
and intrauterine adhesiolysis would be done under general
anaesthesia by using resectoscope and scissors.
Ovulation induction: After excluding other endocrine
diseases, oral ovulation induction drug like clomid is commonly
used in patients with PCOS or normogonadotrophic
normogonadism. Women need to take it for 5 days starting
from day 2 or 3 of their menstrual cycle. During that cycle,
Hysteroscopy: This is a gold standard method to diagnose they need to monitor the treatment response by having basal
pathology within uterine cavity and at the same time, body temperature to check for any biphasic change or doing
therapeutic surgery (excision / removal) can be performed if LH urine kit for any positive LH surge in order to determine
needed. whether the drug is at ovulatory dose. Women can also
have serial ultrasound scans to check for ovulation while
minimizing the chance of multiple pregnancy by cancelling
the treatment cycle if more than one mature follicle achieved.
However, oral ovulation induction drug is not useful in cases
of hypergonadotrophic hypogonadism (ovarian failure) which
needs to consider egg donation while hypogonadotrophic
hypogonadism (hypothalamic / pituitary causes) requires
gonadotrophin injection including both FSH and LH hormones
for folliculogenesis.
www.hkma.org HKMA CME Bulletin 持續醫學進修專訊 January 2021 5
Spotlight
Assisted reproductive technology (ART): intrauterine age. For younger women, such as 30 years old, their
insemination and in-vitro-fertilization success rate could be much higher and up to 40-50%. On
the other hand, for women older than 40, their success
Q Intrauterine insemination with or without ovulation rate can be reduced to 10% or even lower with advancing
induction (IUI +/- OI): During this treatment, women’s age.
menstrual cycle and follicular growth will be monitored
by serial ultrasound scans and hormonal blood tests. For
women with anovulation, ovulation induction medication Conclusion
(oral / injection) is required and will be given since early
follicular phase. On the day of ovulation, washed semen Infertility problem affects 1 in 6 couples. Early recognition of
sample will be inseminated into uterine cavity using a any underlying problem and timely referral for treatment is
fine catheter. The whole treatment cycle takes around important as female fecundity decreases with age especially
2 weeks and a pregnant test will be done 2 weeks after for advanced age women.
the insemination. This treatment option is most suitable
for couple suffering from coital problem which failed References
psychosexual therapy. In addition, IUI can also be used [1] Fertility problems: assessment and treatment. NICE guideline Feb 2013.
in cases with mild abnormal semen parameters and [2] WHO laboratory manual for the examination and processing of human
unexplained cause. The success rate is around 10-15%. semen. Fifth edition, January 2010.
Q In-vitro-fertilization with or without intracytoplasmic
Complete Spotlight, 1 CME Point
sperm injection (IVF +/- ICSI): This treatment takes
Q&A Self-Assessment
will be awarded for at least five
around 2-3 weeks and it consists of (1) controlled CME correct answers
ovarian hyperstimulation using injectable ovulation drugs
Questions:
QUESTIONS:
to achieve multi-follicular growth, (2) follicular growth
Answer these on page 12 or make an online submission at: www.hkma.org.
monitoring by means of ultrasound and hormonal blood Please indicate whether the following statements are true of false.
tests, (3) transvaginal oocyte retrieval under sedation
once follicles reaching mature size, (4) fertilization of 1. Infertility is defined as failure to conceive after 1 year of regular
oocytes and sperms in laboratory by conventional unprotected coitus.
method or ICSI and (5) embryo transfer into uterine 2. Around 1 in 3 couple will suffer from infertility.
cavity under ultrasound guided if good quality embryo 3. Over 80% couple can achieve natural conception within first
year of trying.
available. This treatment is suitable for women with tubo-
4. Unexplained infertility means only semen analysis test is
peritoneal problem especially those with moderate and
abnormal while ovulation test and tubal patency test are
severe cases as fertilization of oocyte and sperm taking normal.
place in laboratory instead of relying on a normal tubo- 5. Psychosexual therapy is considered as the first line treatment
peritoneal environment. Besides, it is also indicated in for couple with coital problem.
men with moderate to severe abnormal semen parameters 6. Women with irregular menstrual cycle should be suspected
as an additional laboratory procedure called ICSI to have ovulation problem and further investigation should be
arranged.
(intracytoplasmic sperm injection), which means injecting
7. Women with previous sexually transmitted disease, pelvic
a sperm with normal motility and morphology directly surgery or dysmenorrhea are considered to be at low risk of
into an oocyte using a micro-needle by embryologist in tubo-peritoneal problem.
laboratory, can be performed during IVF treatment in 8. Women with light menstrual flow and previous uterine surgery
order to optimize the chance of fertilization. For couple should be suspected to have intrauterine adhesion.
with unexplained infertility who failed previous IUI or 9. Assisted reproductive technology consists of intrauterine
insemination and in-vitro-fertilization.
with advancing female age, IVF can also be considered.
10. In-vitro-fertilization IVF has the highest successful treatment
However, IVF is not without risks and its complications rate while no complication is involved.
include ovarian hyperstimulation syndrome (ascites,
pleural effusion, venous thromboembolism etc.) resulting
Answer to December 2020
from ovarian hyperstimulation, internal organs injuries
Spotlight 1 – Life-Time Management Of Aortic Stenosis
(bowel, bladder and pelvic vessels) and infection during
1. T 2. T 3. T 4. F 5. T 6. F 7. T 8. F 9. F 10. T
oocytes retrieval, and multiple pregnancy relating to the
number of embryos being transfer. Couple should be Spotlight 2 – Immunotherapy For Urothelial Carcinoma: What’s
counseled properly before treatment. For the success The Latest Updates?
rate, it is around 30-35% and it greatly depends on female 1. T 2. T 3. F 4. T 5. T 6. T 7. F 8. T 9. F 10. F
6 HKMA CME Bulletin 持續醫學進修專訊 January 2021 www.hkma.org
Cardiology
The content of the January 2021 Cardiology Series is provided by:
Dr. CHEUNG Ling Ling
MBBS(HK), MRCP(UK), FHKCP, FHKAM(Med), Specialist in Cardiology
Dr. Karl CHAN
Complete Cardiology case, MBBS (HK), MRCP (UK)
0.5 CME POINT will be awarded for 一月臨床心臟科個案研究之內容承蒙張玲玲醫生及陳斯畧醫生提供。
at least 2 correct answers in total
A Patient Presenting with Palpitation and Dizziness
A 72 year old lady presented to outpatient clinic
complaining of noticeable palpitations associated with
dizziness for the past 3 months. She was a social smoker
and drinker with a history of myocardial infarction 10 years
ago. She was also diagnosed with hypothyroidism 2 years
ago and now on thyroxine supplement. She had no chest
pain. Physical examination revealed an irregular pulse
and normal apex position, there was no palpable thrill or
heave and no murmur was elicited on auscultation of the
precordium. An ECG was performed (Figure 1).
Figure 1
Q&A
Please answer ALL questions
Answer these on page 12 or make an online submission at: www.hkma.org.
1) What is the rhythm seen in the ECG (Figure 1)? 3) This patient volunteers that she has been
A. Atrial Fibrillation C. Atrial Flutter on regular aspirin ever since her episode of
B. Normal sinus rhythm D. Junctional rhythm myocardial infarction many years ago. What is
your advice regarding the newly diagnosed AF
2) Is she indicated for anticoagulation to reduce and prevention of stroke?
her risk of cardioembolic stroke? A. Advise her to continue the aspirin alone
A. Yes, because her CHA2DS2-VASc score is 2 B. Advise her to continue the aspirin but add on a
B. Yes, because her CHA2DS2-VASc score is 3 direct oral anticoagulant
C. Yes, because anticoagulation is indicated in her C. Advise her to discontinue the aspirin and switch
case regardless of the quantitative stroke risk as to a direct oral anticoagulant
she has a thyroid disorder D. Advise her to discontinue the aspirin and switch
D. No, because her CHADS2 score is 0 to warfarin
December Answers
Explanation Answers: 1. C 2. D 3. B
1. In the attached ECG, the absent of p-wave or “saw-tooth” flutter wave in the baseline, together with irregular
ventricular rate suggest this patient suffering from atrial fibrillation.
2. This is a 62 year-old lady with known history of diabetes and hypertension. Her CHA2DS2-VASc score is 3, so she
has high risks of AF related thromboembolic events and oral anti-coagulation is indicated.
Her symptoms last for more than 48 hours and her haemodynamic condition was stable besides fast AF on
presentation, so she can be treated with medications for rate control (beta-blocker, calcium channel blocker or
digoxin) and oral anti-coagulation. Cardioversion (electrical or pharmacological) can be considered 1) after at
least 3 weeks of adequate anti-coagulation or 2) after performance of transesophageal echocardiogram under
adequate anti-coagulation, which show the absence of left atrial (including left atrial appendage) thrombus.
Immediate cardioversion can also be considered in patients with haemodynamic instability. After cardioversion,
anti-coagulation should be continued for at least 4 weeks irrespective of the CHA2DS2-VASc score. (Fig A)
www.hkma.org HKMA CME Bulletin 持續醫學進修專訊 January 2021 7
Cardiology
8 HKMA CME Bulletin 持續醫學進修專訊 January 2021
www.hkma.orgwww.hkma.org
本診所將於 至 休息，
並於年初 開診。
This clinic will be closed from
to for Lunar New Year.
如有緊急查詢，請致電
In an emergency, please contact
HKMA CME Bulletin 持續醫學進修專訊 January 2021
Cardiology
9Cardiology
3. In patients with symptomatic paroxysmal atrial fibrillation or symptomatic persistence atrial fibrillation without
major risk factors of AF recurrence (significantly enlarged LA volume, advanced age, long AF duration, renal
dysfunction and other cardiovascular risk factors), both anti-arrhythmic drugs or catheter-based AF ablation
(Class IIa for symptomatic paroxysmal AF and Class IIb for symptomatic persistence AF without major risk factors)
can be considered after detailed discussion with patients concerning the pros and cons of each strategies. If the
patient remained in symptomatic atrial fibrillation despite optimal anti-arrhythmic medications, catheter-based AF
ablation is indicated. (Fig B)
Fig A
Fig B
LAA closure maybe considered for stroke prevention in patients with AF with elevated stroke risks and
contra-indications for long term anticoagulation.
In patients with AF and symptomatic bradycardia, which is often related to underlying sick sinus syndrome and
maybe exacerbated by antiarrhythmic therapy, pacemaker implantation is indicated.
Reference: The content of the December 2020 Cardiology Series is provided by:
2020 ESC Guidelines for the diagnosis and management of Dr. CHUI Shing Fung
atrial fibrillation developed in collaboration with the European MBChB (CUHK), MRCP (UK), FHKCP, FHKAM (Medicine), Specialist in Cardiology
Association for Cardio-Thoracic Surgery (EACTS). European Dr. WONG Chi Yuen
MBBS (HK), FHKCP, FHKAM (Medicine), FRCP (Edin), Specialist in Cardiology
Heart Journal (2020) 00, 1-126.
十二月臨床心臟科個案研究之內容承蒙徐城烽醫生及黃志遠醫生提供。
10 HKMA CME Bulletin 持續醫學進修專訊 January 2021
www.hkma.orgDermatology
Dermatology Series for January 2021 is provided by:
Dr. LEUNG Wai Yiu, Dr. TANG Yuk Ming, William,
Dr. CHAN Hau Ngai, Kingsley, Dr. KWAN Chi Keung and Dr. NG Shun Chin
Specialists in Dermatology & Venereology
Complete Dermatology case, 一月皮膚科個案研究之內容承蒙梁偉耀醫生、鄧旭明醫生、陳厚毅醫生、
0.5 CME POINT will be awarded for 關志強醫生及吳順展醫生提供。
at least 2 correct answers in total
A Lady With Itchy Skin Rash On Her Legs
A 73-year-old female complained of itching on the legs and noticed
multiple red fissures on her shin for several weeks. The patient has a
history of diabetes but not any past medical history of autoimmune or
endocrine diseases. She is not on any medication such as retinoid.
Physical examination revealed erythematous plaque of polygonal
fissures with exudate and yellow crust on her shin. She recalled similar
pruritic rashes on her legs last winter, which resolved when the weather
was warmer.
Q&A
Please answer ALL questions
Answer these on page 12 or make an online submission at: www.hkma.org.
1. What is the clinical diagnosis? 3. Are these skin lesions more pronounced in
A. Cellulitis C. Livedo reticularis winter? (T/F)
B. Asteatotic eczema D. Contact dermatitis
4. Which of the following is NOT a treatment
2. Who is more prone to this skin disease? option for this patient?
A. Female A. Patient education and reassurance
B. Patient with ichthyosis B. Low potency steroid cream
C. Patient with autoimmune disease C. Systemic antibiotics
D. Elderly D. Frequent Emollient/ Moisturizers
I. A+C III. All
II. B+D IV. None of the above
December Answers
1. E 5. E
The clinical diagnosis is seborrheic dermatitis. It is a Medicated shampoo containing ketoconazole. tar,
common, chronic for of eczema and mainly affecting the selenium sulfide etc can be used to decrease the
sebaceous gland rich area, like the scalp, face and trunk. scales over scalp. Steroid scalp application help to
It is non infectious and usually worsen in dry weather. decrease itchness and can be stopped once the
symptom subsided. Topical immunosuppressant like
2. F calcineurin inhibitor can be as used as alternative to
Infantile seborrhoic dermatitis usually affects babies steroid. Combination treatment is usually needed to treat
under 3 months of age and usually resolves around 1 seborhoic dermatitis.
year old. Adult seborrhoic dermatitis usually affects late
adolescence and it is more common in males than in
females.
3. E
Seborrhoic dermatitis usually presents as red scaly rash
over scalp, but it can also occur over eyebrow, ear, nose,
upper trunk, etc.
4. F The content of the December 2020 Dermatology Series is provided by:
Seborrhoic dermatitis is best to be diagnosed clinically. Dr. CHAN Hau Ngai, Kingsley, Dr. TANG Yuk Ming, William,
Dr. KWAN Chi Keung, Dr. LEUNG Wai Yiu and Dr. NG Shun Chin,
No skin biopsy or blood checking is usually needed for Specialists in Dermatology & Venereology
most cases 十二月皮膚科個案研究之內容承蒙陳厚毅醫生、鄧旭明醫生、關志強醫生、
梁偉耀醫生及吳順展醫生提供。
www.hkma.org HKMA CME Bulletin 持續醫學進修專訊 January 2021 11Name Signature:
Answer Sheet HKMA Membership No.
Contact Tel No.:
HKID No. - xxx(x)
January 2021
ANSWER SHEET
Please answer ALL questions and write the answers in the space provided. Please return the
completed answer sheet
SPOTlight
to the HKMA Secretariat
Complete Spotlight, 1 CME point will be awarded for at least 5 correct answers
(Fax: 2865 0943) on or
1 2 3 4 5 6 7 8 9 10 before 15 February 2021
for documentation.
If you complete
Cardiology Dermatology the exercise online,
Complete Cardiology, 0.5 CME point will be Complete Dermatology, 0.5 CME point will be you are NOT required to
awarded for at least two correct answers awarded for at least two correct answers return the answer sheet by fax.
1 2 3 1 2 3 4
A maximum of 20 points can
be awarded for self-study
per year and no upper limit of
CME points for attending CME
lectures
CME Physical Lecture Policy and Procedure
Registration Online payment available ONLY for attending a single lesson, payment for
1. Please complete the reply slip and return to HKMA Secretariat in person package is unavailable currently.
or by fax/mail/email. CME Self-Studies Series
2. Enrollment priorities will be given to doctors who have purchased You can register the CME Lectures and finish the CME Self-Studies Series
packages. For Community Network Lectures, priorities will be given to within the webpage (www.hkma.org).
doctors from that Community Network with Packages, then doctors Don’t wait! Please register and create your own account through https://
from that Community Network. www.thkma.org/members/register.php (1st time register account is limited
3. No walk in or on-site payment will be accepted. Attendance without on desktop ONLY) to experience our new Members Portal.
registration will not be recognized and CME point will not be accredited. Information for Participants
4. Please ensure that your registration is confirmed before attending Special weather arrangement
lecture. Only successfully registered doctors who paid could attend the When Tropical Storm Warning Signal No. 8 (or above) or a Black Rainstorm
lecture. Warning Signal is in force within 3 hours of the commencement time, the
5. The HKMA Secretariat will notify doctors who have successfully enrolled relevant CME function will be cancelled. (i.e. CME starting at 2:00 pm will be
to arrange for payment. If doctors have not arranged for payment within cancelled if the warning signal is hoisted or in force any time between 11:00
a specified period after the notification, the seat will be released to am and 2:00 pm).
doctors on waiting list without further notice.
The function will proceed as scheduled if the signal is lowered three hours
Payment before the commencement time. (i.e. CME starting at 2:00 pm will proceed
1. All HKMA CME lectures that involve registration and enrollment through if the warning signal is lowered at 11:00 am, but will be cancelled even if it is
the HKMA would require the collection of lecture fee (unless otherwise lowered at 11:01 am).
specified).
2. The lecture fee is $50 for HKMA members and $100 for non-members When Typhoon No. 8 Signal or a Black Rainstorm signal is in force after
per lecture. CME commencement, announcement will be made depending on the
3. Online payment is available to doctors who have registered the HKMA conditions as to whether the CME will be terminated earlier or be conducted
website online system. One transaction is for one lecture only. until the end of the session.
4. Packages could be purchased through cash or cheque only. The above are general guidelines only. Individuals should decide on their
5. Cash payments have to be paid in person at HKMA Secretariat and CME attendance according to their own transportation and work/home
cheque payments have to be mailed or paid in person at HKMA location considerations to ensure personal safety.
Secretariat. General lecture policy
6. Fee can be paid together in one cheque for lecture within the same 1. Doctor should sign for own CME.
month. Only combined cheque payment for not more than 2 packages 2. Registration will cease when Q & A Session starts.
will be accepted. 3. No recording unless permission is granted by the HKMA.
7. No refund or transfer will be allowed after payment is made. Payment 4. If doctor has attended CME Lecture and CME Live at the same point of
cannot be transferred to other lectures or for other specified doctors. time, only CME Points for the Lecture would be counted.
CME Online Payment & CME Self-Studies Series 5. The HKMA will investigate when non-compliance at CME Session is
CME Online Payment reported, further action will be considered to ensure all CME activities
The HKMA is excited to introduce online payment for CME Lectures: are properly held.
1. Login to CME Portal to apply for a lecture 6. For enquiries, please contact the CME Department of the HKMA
2. Receive SMS notification Secretariat at 2527-8452.
3. Pay online!
(revised in August 2019)CME Live CME notifications
The HKMA CME Live Lectures in January 2021
All lectures start at 2:00-3:00 p.m.
CME
Accreditation
CME from Colleges
Date Organizer and Topic Speaker Points (Pending)#
1. 20 January HKMA Dr. NGAI Chi Fung 1 Pending
(Wed) Update on Management of Fatty Liver Specialist of Gastroenterology and
Disease Hepatology
Sponsor: Abbott Laboratories Limited
2. 22 January HKMA Dr. JIM Man Hong 1 Pending
(Fri) Optimized choice of anticoagulation Specialist in Cardiology
-NOAC in high risk AF patients
Sponsor: Daiichi Sankyo Hong Kong
Limited
3. 23 January HKMA & Hong Kong Elderly 1. Dr. WONG Tai Hung, John 2 Yes
(Sat) Welfare Foundation Specialist in Cardiology
2:00-3:45 p.m. 1. LUTS and Heart Diseases (CHF) 2. Dr. CHU Wing Hong
2. LUTS And Mortality (Falls And Specialist in Urology
Fractures) 3. Dr. CHEON Willy Cecilia
3. LUTS And Incontinence Consultant (O&G) Head, Urogynaecology
Sponsor: Hong Kong Elderly Welfare Team in O&G Dept, QEH
Foundation Dr. CHAN Yuen Mei, Toby
Associate Consultant, Urogynaecology
Team in O&G Dept, QEH
4. 26 January HKMA Yau Tsim Mong Community Dr. CHOW Man Po 1 Yes
(Tue) Network Specialist in General Surgery
Lecture Series on Surgery (Session 1)
– Colorectal Cancer Prevention and
Treatment Updates
5. 27 January HKMA Dr. Martin WONG 1 Yes
(Wed) Personalized treatment for Specialist in Urology
management of BPH
Sponsor: Synmosa Biopharma (HK)
Co Ltd
6. 28 January HKMA New Territories West Dr. CHAN Ki Wan, Kelvin 1 Yes
(Thu) Community Network Specialist in Cardiology
Diagnosis and Management for
Chronic Coronary Syndrome
Sponsor: Sanofi Hong Kong Ltd.
7. 29 January HKMA Dr. CHAN Pak To 1 Pending
(Fri) Management of Rheumatoid Arthritis. Specialist in Rheumatology
What is the update in 2020?
Sponsor: AbbVie Limited
8. 30 January HKMA 3D Printing Interest Group 1. Prof. Alex PW LEE 1.5 Pending
(Sat) 1. 3D Printing in clinical medicine. Professor & Honorary Consultant
3:00-4:30 p.m. Sharing our knowledge and current Cardiologist, CUHK
methods between different specialties 2. Prof. Richard SU
– a series of short lectures and Clinical Associate Professor in Oral and
discussion Maxillofacial Surgery, HKU
2. Round table discussion 3. Mr. Joseph CHENG
Senior Occupational Therapist, CMC
4. Mr. Gabriel CHU
Prosthetist-Orthotist I, UCH
5. Dr. Christian FANG
Clinical Associate Professor, Department
of Orthopaedics and Traumatology, HKU
6. Dr. Damian MAK
Associate Consultant, Department of
Orthopaedics and Traumatology, North
District Hospital
www.hkma.org HKMA CME Bulletin 持續醫學進修專訊 January 2021 13CME notifications CME Live
The HKMA CME Live Lectures in February 2021
All lectures start at 2:00-3:00 p.m.
**The final arrangement of the Live sessions might subject to changes, please refer to the RCS and the list post in the
Facebook Group for the most updated arrangement.**
CME
Accreditation
CME from Colleges
Date Organizer and Topic Speaker Points (Pending) #
1. 2 February The Hong Kong Medical Association & Dr. LI Chung Ki, Patrick 1 Yes
(Tue) Hong Kong Sanatorium & Hospital Specialist in Neurology
Updates on Acute Stroke Management
Sponsor: Hong Kong Sanatorium & Hospital
2. 4 February HKMA Kowloon East Community Network Dr. CHAN Chi Wing, Timmy 1 Yes
(Thu) Chronic Pain Management Consultant,
Sponsor: Abbott Laboratories Limited Department of Anaesthesiology,
Queen Mary Hospital
3. 9 February HKMA Kowloon West Community Network Dr. WONG King Ying 1 Yes
(Tue) Safety & Efficacy of Corticosteroids for Asthma Specialist in Respiratory
Treatment Medicine and Internal Medicine
Sponsor: GlaxoSmithKline Limited
4. 10 February HKMA Central, Western & Southern Dr. IP Ka Lun 1 Pending
(Wed) Community Network Specialist in
Management of Tonsillitis and Carcinoma of Otorhinolaryngology
Larynx
Sponsor: Medtronic Hong Kong Medical
Limited
5. 18 February HKMA New Territories West Community Dr. LAU Chun Leung 1 Yes
(Thu) Network Specialist in Cardiology
Leading the Shift in Paradigm in T2D
Treatments: Cardio-Protection with Glucose-
Lowering Drug
Sponsor: Boehringer Ingelheim (Hong Kong)
Limited
6. 23 February The Hong Kong Medical Association & the Dr. WAN Chi Kin 1 Yes
(Tue) Gleneagles Hong Kong Hospital Specialist in Respiratory
CA lung /Lung Nodules and Ground Glass Medicine
Opacities: how should we manage them? Dr. SIHOE Dart Loon, Alan
Sponsor: Gleneagles Hong Kong Hospital Specialist in Cardio-thoracic
Surgery
7. 25 February HKMA Hong Kong East Community Network Dr. NG Ka Kin 1 Yes
(Thu) Hemorrhoids... A Common Disease and Specialist in General Surgery
Effective Treatment Options
Sponsor: Servier Hong Kong Ltd
8. 26 February HKMA Yau Tsim Mong Community Network Dr. KAN Mei Yee, Daisy 1 Yes
(Fri) Lecture Series on Surgery (Session 2) - Non- Consultant,
Surgical Treatment of Benign Thyroid Nodule Department of Surgery,
Kwong Wah Hospital
Please register through https://forms.gle/fEfbjYihuE81qyni6 or scan the QR code placed on the left if you are interested
to attend. For enquiry, please contact the Secretariat at 2527 8285.
#
Accreditation from various colleges pending, for specialists, please completed the quiz online within two hours after
the lecture with at least 50% correct for CME/ CPD points. For lecture without “Yes”, CME Accreditation is for Non-
Specialists Only. Non-Specialists doctors must complete lecture quiz (10 Q&A) and answer questions within two hours
after the lecture with at least 50% correct.
14 HKMA CME Bulletin 持續醫學進修專訊 January 2021
www.hkma.orgCME Live CME notifications
HKMA-HKSH and HKMA-GHK
CME Programme 2021
All lectures start at 2:00-3:00 p.m.
Date HKSH Programme Speaker
02 February 2021 (Tue) Updates On Acute Stroke Management Dr. LI Chung Ki, Patrick
Specialist in Neurology
02 March 2021 (Tue) The Application & Effectiveness Of Allergen Dr. CHAN Wai Ming, Alson
Immunotherapy In Co-Morbid Allergic Diseases Specialist in Paediatric Immunology,
Allergy and Infectious Diseases
13 April 2021 (Tue) 10 Things That You Need Know About Prostate Cancer Dr. POON Ming Chun, Darren
Specialist in Clinical Oncology
04 May 2021 (Tue) Recent Advance In GORD Dr. KWONG Wing Hang
Specialist in General Surgery
01 June 2021 (Tue) Common Upper Limb Fractures And Options Of Dr. KOU Sio Kei
Treatment Specialist in Orthopaedics &
Traumatology
06 July 2021 (Tue) Surgical Management Of Lymphoedema Dr. CHOI Wing Kee
Specialist in Plastic Surgery
03 August 2021 (Tue) Glaucoma - Beyond Intraocular Pressure, The Updates Dr. BAIG, Nafees Begum
We Should Know Specialist in Ophthalmology
Date GHK Programme Speaker
23 February 2021 (Tue) CA Lung /Lung Nodules And Ground 1. Dr. WAN Chi Kin
Glass Opacities: How Should We Manage Them? Specialist in Respiratory Medicine
2. Dr. SIHOE Dart Loon, Alan
Specialist in Cardio-thoracic
Surgery
12 March 2021 (Fri) Update On Minimally Invasive Spine Surgery Dr. LAM Cheung Hing, Eric
Specialist in Orthopaedics &
Traumatology
20 April 2021 (Tue) Update On Management Of Peritoneal Malignancy Dr. Jeremy YIP
Specialist in General Surgery
25 May 2021 (Tue) Update On Renal Stone Management Dr. CHUNG Yeung, Vera
Specialist in Urology
22 June 2021 (Tue) Management On Musculoskeletal Tumor Dr. SO Yat Cheong, Timothy
Specialist in Orthopaedics &
Traumatology
CME Accreditation: 1 CME point per day #
Registration: Please scan the QR code or register through https://forms.gle/pHfp3YbkcWSvqbxa9
Registration Deadline: Monday, 8 February 2021
Enquiry: CME Department, Tel: 2527 8285 / cme@hkma.org
#
Accreditation from various colleges pending. For Specialists, please completed the quiz online within two hours
after the lecture with at least 50% correct for CME/CPD point(s). For Non-Specialists Doctors, please completed the
quiz online within two hours after the lecture with at least 50% correct for CME point(s).
www.hkma.org HKMA CME Bulletin 持續醫學進修專訊 January 2021 15Meeting Highlights
The Hong Kong Medical Association
Dr. MAK Siu King (2nd speaker of the roll), Dr. Jennifer
Ma Wai Wai MYINT (3rd speaker of the roll) and
Prof. YING Tin-Cheung, Michael (1st speaker of the
Dr.WONG Y at Hin, Ian presenting a CME Live Lecture on Dr. LAU Cham Yat,Vincent presenting a CME Live Lecture on roll) presenting a CME Live LUTS Series Half-Day
1December 2020 18 December 2020 Symposium on19 December 2020
The HKMA Hong Kong East The HKMA Kowloon West
Community Network (HKECN) Community Network (KWCN) The HKMA Shatin Community
~ Dr. CHAN Nim Tak, Douglas ~ Dr. TONG Kai Sing Network (SCN)
Dr. Ray CHAN presenting a CME Live Lecture Dr. Gary CHEUNG presenting a CME Live Lecture Dr. Alfred T AM presenting a CME Live Lecture
on17 December 2020 on 4 December 2020 on16 December 2020
HKMA CME Bulletin
Monthly Self-Study Series Call for Articles
Since its publication, the HKMA CME Bulletin has become one of the most popular CME readings for doctors. This
monthly publication has been serving more than 10,000 readers each month through practical case studies and picture
quizzes. To enrich its content, we are inviting articles from experts of different specialties. Interested contributors may
refer to the General Guidance below. Other formats are also welcome.
For further information, please contact CME Dept. at 2527 8452 or by email at cme@hkma.org.
General Guidance for Authors
Intended Readers : General Practitioners
Length of Article : Approximately 8-10 A-4 pages in 12-pt fonts in single line spacing, or around 1,500-2,000 words
(excluding references).
Review Questions : Include 10 self-assessment questions in true-or-false format.
(It is recommended that analysis and answers to most questions be covered in the article.)
Language : English
Highlights : It is preferable that key messages in each paragraph/section be highlighted in bold types.
Key Lessons : Recommended to include, if possible, a key message in point-from at the end of the article.
Others : List of full name(s) of author(s), with qualifications and current appointment quoted, plus a digital
photograph of each author.
Deadline : All manuscripts for publication of the month should reach the Editor before the 1st of the previous
month.
All articles submitted for publication are subject to review and editing by the Editorial Board.
We welcome submissions for consideration which are original and not under consideration for any other
publication at the same time. Articles submitted will be checked using originality detection software. For details
please contact CME Bulletin Editorial Office of the HKMA.
16 HKMA CME Bulletin 持續醫學進修專訊 January 2021
www.hkma.orgCME Calendar
January 2021 February 2021
20 January The Hong Kong Medical Association 2 February The Hong Kong Medical Association & Hong Kong
(Wed) Update on Management of Fatty Liver Disease 1 (Tue) Sanatorium & Hospital 1
2:00-3:00 p.m. HKMA Facebook CME Live Lecture 2:00-3:00 p.m. Updates on Acute Stroke Management
HKMA CME Dept. – Tel: 2527 8452 HKMA Facebook & Zoom CME Live Lecture
22 January The Hong Kong Medical Association HKMA CME Dept. – Tel: 2527 8452
(Fri) Optimized choice of anticoagulation -NOAC in high risk 1
4 February HKMA Kowloon East Community Network
2:00-3:00 p.m. AF patients (Thu) Chronic Pain Management 1
HKMA Facebook CME Live Lecture 2:00-3:00 p.m. HKMA Facebook CME Live Lecture
HKMA CME Dept. – Tel: 2527 8452 HKMA CME Dept. – Tel: 2527 8452
23 January HKMA & Hong Kong Elderly Welfare Foundation 9 February HKMA Kowloon West Community Network
(Sat) 1. LUTS and Heart Diseases (CHF) 2 1
(Tue) Safety & Efficacy of Corticosteroids for Asthma
2:00-3:45 p.m. 2. LUTS And Mortality (Falls And Fractures) 2:00-3:00 p.m. Treatment
3. LUTS And Incontinence HKMA Facebook CME Live Lecture
HKMA Facebook & Zoom CME Live Lecture HKMA CME Dept. – Tel: 2527 8452
HKMA CME Dept. – Tel: 2527 8452 10 February HKMA Central, Western & Southern Community
26 January HKMA Yau Tsim Mong Community Network (Wed) Network 1
(Tue) Lecture Series on Surgery (Session 1) – Colorectal 1
2:00-3:00 p.m. Management of Tonsillitis and Carcinoma of Larynx
2:00-3:00 p.m. Cancer Prevention and Treatment Updates HKMA Facebook CME Live Lecture
HKMA Facebook CME Live Lecture
HKMA CME Dept. – Tel: 2527 8452
HKMA CME Dept. – Tel: 2527 8452
18 February HKMA New Territories West Community Network
27 January The Hong Kong Medical Association 1
1 (Thu) Leading the Shift in Paradigm in T2D Treatments:
(Wed) Personalized treatment for management of BPH
2:00-3:00 p.m. Cardio-Protection with Glucose-Lowering Drug
2:00-3:00 p.m. HKMA Facebook CME Live Lecture
HKMA Facebook CME Live Lecture
HKMA CME Dept. – Tel: 2527 8452
HKMA CME Dept. – Tel: 2527 8452
28 January HKMA New Territories West Community Network
1 23 February The Hong Kong Medical Association & the
(Thu) Diagnosis and Management for Chronic Coronary 1
(Tue) Gleneagles Hong Kong Hospital
2:00-3:00 p.m. Syndrome
HKMA Facebook CME Live Lecture 2:00-3:00 p.m. CA lung/Lung Nodules and Ground Glass Opacities:
HKMA CME Dept. – Tel: 2527 8452 how should we manage them?
HKMA Facebook & Zoom CME Live Lecture
29 January The Hong Kong Medical Association
(Fri) Management of Rheumatoid Arthritis. What is the 1 HKMA CME Dept. – Tel: 2527 8452
2:00-3:00 p.m. update in 2020? 25 February HKMA Hong Kong East Community Network
(Thu) Hemorrhoids... A Common Disease and Effective 1
HKMA Facebook CME Live Lecture
HKMA CME Dept. – Tel: 2527 8452 2:00-3:00 p.m. Treatment Options
30 January HKMA 3D Printing Interest Group HKMA Facebook CME Live Lecture
(Sat) 1. 3D Printing in clinical medicine. Sharing our 1.5 HKMA CME Dept. – Tel: 2527 8452
3:00-4:30 p.m. knowledge and current methods between different 26 February HKMA Yau Tsim Mong Community Network
(Fri) Lecture Series on Surgery (Session 2) - Non-Surgical 1
specialties – a series of short lectures and discussion
2. Round table discussion 2:00-3:00 p.m. Treatment of Benign Thyroid Nodule
HKMA Facebook & Zoom CME Live Lecture HKMA Facebook CME Live Lecture
HKMA CME Dept. – Tel: 2527 8452 HKMA CME Dept. – Tel: 2527 8452
Receiving Electronic Copy Of CME Bulletin
The CME Bulletin has been mailed to members on the 15th of each month since year 2000. As an initiative to protect the
environment and smart costing, HKMA encourages members to receive these documents via email or read them online at
the HKMA website (http://www.hkma.org/), rather than receiving hard copies by post.
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please indicate your preference by filling in the reply slip below.
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www.hkma.org HKMA CME Bulletin 持續醫學進修專訊 January 2021 17
Please return the completed form to us by fax (2865 0943) or email (cme@hkma.org).UP TO
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