HAZARDS OF COMPLEMENTARY AND ALTERNATIVE MEDICINE Dear Sir,

We read with interest the case report by Su et al published in the January 2007 issue of the journal, which reported a case of bilateral pneumothorax secondary to acupuncture with tension pneumothorax on one side requiring urgent chest tube insertion.(1) This case report highlights the hazards of acupuncture, a popular form of complementary and alternative medicine (CAM) most commonly used among the Chinese. CAM is widely practised across the age groups and cultural divide, and most clinicians have in their career encountered cases of adverse effects of CAM use. We similarly encountered a potentially fatal case of CAM use in a lady who had just delivered. A 27-year-old woman was brought into the emergency department after being found unconscious by her husband in a smoke-fi lled room at home. The windows were all closed. She had just delivered eight days before presentation. She was treated with high fl ow oxygen and she slowly regained consciousness. Chest examination was normal. Chest radiography did not show any abnormalities. Admitting blood gas only showed mild hypoxia. She was admitted overnight for observation, and was well and discharged the following day. She mentioned that she was undergoing a kind of traditional CAM therapy locally known as “berdiang”. After starting the therapy, she felt dizzy from the heat and smoke and was not able to open the window before passing out. “Berdiang ” is a local term to describe an age-old traditional practice of treatment applied after delivery and is believed to aid in the recovery from the process of labour and also aid in shedding the excess tissue gained around th