Purpose: This study aims to examine the prevalence of overweight and obesity in children with type 1 diabetes mellitus (T1DM) in Hong Kong and to evaluate the association between obesity, glycemic control, and metabolic comorbidities. Methods: A retrospective cross-sectional study was conducted from 2022–2023 at the Hong Kong Children’s Hospital, enrolling all children with T1DM. Anthropometric measurements and biochemical data were extracted from medical records, and prevalence rates of metabolic complications were compared. Results: One hundred twenty-six children (41% male, 89% Asian) with a median age of 12.8 years were included. Of these, 17.5% were either overweight or obese. There were no significant differences in hemoglobin A1c values between the normal-weight and overweight/obesity groups, though the latter group required higher total daily insulin doses. Children with overweight/obesity had higher prevalence rates of hypertension (28.6% vs. 2.9%) and dyslipidemia (90.5% vs. 71.9%). They were also more likely to have hypertension (adjusted odds ratio [aOR], 18.48; 95% confidence interval [CI], 3.42–99.94) and hypertriglyceridemia (aOR, 7.71; 95% CI, 1.66–35.76). The overweight/obese group also exhibited significantly higher alanine aminotransferase levels (median, 18 IU/L vs. 14 IU/L), non–high-density lipoprotein cholesterol (HDL-C) levels (median, 3.3 mmol/L vs. 2.9 mmol/L), and triglyceride/HDL-C ratios (median, 1.09 vs. 0.52) and lower HDL-C levels (median, 1.4 mmol/L vs. 1.6 mmol/L). Among those with dyslipidemia, only 8% were started on lipid-lowering agents, while none of those with hypertension were started on antihypertensive agents. Conclusion Despite a lower prevalence of overweight/obesity in Asian children with T1DM compared to Western populations, metabolic comorbidities occur at an exceptionally high rate. Early interventions to tackle these modifiable cardiovascular risk factors are crucial to prevent long-term complications.

Background: Vaccination is a cost-effective primary preventive measure against infectious diseases. However, protection for specific diseases may wane over time. The National Immunization Program was launched to improve vaccine coverage but despite this, some countries including the Philippines have erratic vaccine coverage. Objective: To determine the compliance to the National Immunization Program of Grade 1 students in a public elementary school Methodology: The study utilized a descriptive cross-sectional design. Simple random sampling of students enrolled in first grade for A.Y. 2017-2018 was done to determine the study respondents. Primary and secondary data were obtained through a pretested structured questionnaire with interview of the students’ caregiver and verification via the students’ immunization records. Compliance to immunization was correlated with the subjects’ age, birth rank, primary caregiver and socio-demographic profile of the caregiver, place of birth and place of vaccination. Data were analyzed using descriptive statistics and logistic regression was used to assess factors for increased vaccination compliance. Results: Most respondents had their mothers as primary caregivers. Majority were institutional deliveries and immunized at a health center. Mean compliance to vaccination was 69%. Among the factors, only place of birth, specifically, hospital delivery, was associated with increased compliance to vaccination (OR = 0.3312, 90% CI 0.1496 to 0.7333, p value 0.0064). Subjects whose primary caregivers were the mothers and whose parents had higher educational attainment or were both employed were shown to have higher vaccination compliance, although this was not statistically significant. Vaccination coverage was observed to decrease over time as the subjects grew older. Most common reasons cited for missing vaccinations were vaccine unavailability (68%), financial constraints 46%), and lack of information (40%). Conclusion Compliance to vaccination in this study was 69% and is affected by multiple factors. Policymakers and stakeholders should address these barriers to improve vaccination coverage and overall health status.
Immunization ; Vaccines ; Child

Although colonoscopy was originally a diagnostic imaging procedure, it has now expanded to include an increasing range of therapeutic interventions. These procedures require precise maneuvers of instruments, execution of force, efficient transmission of force from the operator to the point of application, and sufficient dexterity in the mobilization of endoscopic surgical instruments. The conventional endoscope is not designed to support technically demanding endoscopic procedures. In case of colonoscopy, the tortuous anatomy of the colon makes inserting, moving, and orientating the endoscope difficult. Exerting excessive pressure can cause looping of the endoscope, pain to the patient, and even perforation of the colon. To mitigate the technical constraints, numerous technically enhanced systems have been developed to enable better control of instruments and precise delivery of force in the execution of surgical tasks such as apposing, grasping, traction, counter-traction, and cutting of tissues. Among the recent developments are highly dexterous robotic master and slave systems, computer-assisted or robotically enhanced conventional endoscopes, and autonomously driven locomotion devices that can effortlessly traverse the colon. Developments in endoscopic instrumentations have overcome technical barriers and opened new horizons for further advancements in therapeutic interventions. This review describes examples of some of these systems in the context of their applications to advanced therapeutic colonoscopy.
Colon ; Colonoscopy* ; Diagnostic Imaging ; Endoscopes ; Hand Strength ; Humans ; Locomotion ; Robotics* ; Slaves ; Surgical Instruments ; Traction