Radiologically detected intranodal thyroid tissues in ipsilateral cervical lymph nodes after hemithyroidectomy in a pediatric patient.

This case report illustrates the presence of intranodal thyroid tissues in ipsilateral cervical lymph nodes after hemithyroidectomy for multinodular goiter in an adolescent patient. It highlights the rare radiological finding of thyroid tissues within cervical lymph nodes detected by ultrasonography and computed tomography, which is a great mimicker of nodal metastasis.

Therapeutic effect of Duhuo Jisheng Decoction add-on Tui-na manipulation on osteoarthritis of knee: a randomized controlled trial.

BACKGROUND: Knee osteoarthritis (KOA) is a common degenerative joint condition that causes disability and pain in the elderly population. The prevalence of KOA among persons aged 63 or above is approximately 30%. Previous studies have reported the positive effects of Tui-na treatment and the Chinese herbal formula Du-Huo-Ji-Sheng Decoction (DHJSD) for KOA treatment. The current study aims to evaluate the add-on therapeutic effect of oral administration of DHJSD on KOA in addition to Tui-na. METHODS: We conducted a prospective, randomized, controlled clinical trial. Seventy study subjects with KOA were randomly assigned to the treatment and control groups in a 1:1 ratio. Both two groups received eight sessions of Tui-na manipulation for 4 weeks. The DHJSD was only administered to the study subjects in the treatment group. The primary outcome measure was rated using the WOMAC at the end of treatment (4 weeks). Secondary outcomes were assessed using EQ-5D-5L, a health-related quality of life with 5-level EQ-5D version at end of treatment (week 4) and follow-up (week 8). RESULTS: No statistically significant difference was found between two groups on WOMAC scores at the end of treatment. The mean WOMAC Pain subscale score was significantly lower in the treatment group than control group at week 8 follow up (mean difference, MD - 1.8, 95% CI - 3.5 to - 0.02, P = 0.048). The mean WOMAC Stiffness subscale score was significantly lower in the treatment group than in the control group at week 2 (MD 0.74, 95% CI 0.05 to 1.42, P = 0.035) and week 8 follow up (MD 0.95, 95% CI 0.26 to 1.65, P = 0.008). The mean EQ-5D index value was significantly improved in the treatment group than in the control group at week 2 (MD 0.17, 95% CI 0.02 to 0.31, P = 0.022). The analysis of WOMAC scores and EQ-5D-5L in both groups showed statistically significant improvement with time. No significant adverse effect was found during the trial. CONCLUSION: DHJSD may have an add-on effect in addition to Tui-na manipulation relieving pain and improving stiffness as well as quality of life (QOL) in patients with KOA. The combined treatment was generally safe and well tolerated. Trial registration The study was registered at the ClinicalTrials.gov (website: https://clinicaltrials.gov/ct2/show/NCT04492670 , registry number: NCT04492670), registered on 30 July 2020.

A survey of attitudes to traditional chinese medicine among Chinese medical students.

We studied the attitudes and personal experiences with traditional Chinese Medicine (TCM) use in Chinese medical students. Medical students at the Chinese University of Hong Kong were asked 13 questions according to an anonymous survey. Six hundred and eleven of 780 medical students (47% males, 52% females) returned the questionnaire; 199 (33%) of the participants used TCM at least once in the past year, and 85% had ever tried various TCM. The attitude was positive in 41%, neutral in 52% and negative in only 6%. The majority (70%) reported no change in attitudes towards TCM after studying Western medicine (WM). Of the 199 participants who had used TCM in the past year, upper respiratory infections were the most common circumstance leading to TCM usage, with 31% immediately using TCM without any TCM practitioner consultation. The most common modality of TCM used by 85% of participants was herbal decoction, and nearly one-quarter had used over-the-counter Chinese medicine. Although 78% reported they knew of the TCM practitioner or treatment from family members or friends, 14% stated they randomly selected the practitioner. "Effectiveness of TCM," "fewer side effects than WM," "illness not completely treated by WM" and "recommendation from family/friends" were common beliefs held by participants for TCM usage. Forty-five percent reported that they had not been told of any side effects of TCM. Pre-clinical students had more positive attitudes towards TCM and consulted TCM practitioners more often in the past 12 months (OR 9.1, CI 3.16-28.18; p < 0.001) compared to students in clinical years, who tended to become more negative towards TCM after studying WM. TCM usage is common among medical students in Hong Kong. It is important to note that nearly half of the students were not aware of any possible side effects from TCM. Students appear to become more negative towards TCM after studying WM.

Incidence of chest wall paresthesia after video-assisted thoracic surgery for primary spontaneous pneumothorax.

OBJECTIVE: Video-assisted thoracic surgery (VATS) is an established treatment for recurrent or complicated primary spontaneous pneumothorax (PSP). However, a proportion of patients still complains of chronic pain or discomfort after VATS pleurodesis. We aimed to investigate if paresthesia is a distinct component of the post-operative discomfort in patients receiving VATS for PSP. METHODS: Telephone interviews were conducted with 52 patients who had received VATS pleurodesis for PSP in our institute during a defined 24 month period. A standardized questionnaire was used to identify paresthetic discomforts which the patients themselves could distinguish from their wound pain. Responses were obtained from 51 patients (42 male, 9 female) with a mean age of 24.1 years (range 14-63 years), giving a response rate of 98.0%. RESULTS: With a median observation time of 19 months (range 2-24 months), 27 patients (52.9%) reported experiencing paresthesia as a post-operative complication distinct from their wound pain. The most commonly described characteristics of the paresthesia were 'pins and needles' (37.0%), 'numbness' (25.9%) or a sensation of abnormal 'swelling' in the chest wall (11.1%). Although only two of the affected patients (7.4%) described the paresthesia as 'severe', consequent functional disturbances in daily life were noted by seven patients (25.9%), and 11 patients (40.7%) actively sought medical or alternative, holistic therapies to relieve the paresthesia. Eight (21.0%) of the 38 patients followed-up for over 12 months after surgery still experienced the paresthesia. CONCLUSIONS: Although it should not detract from the proven advantages of VATS, paresthesia in the chest wall represents a distinct but previously overlooked post-VATS complication. It is a potential source of significant post-operative morbidity, and may run a chronic course in some patients. Further study is warranted to elucidate its mechanisms and optimum management.