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Table of Contents - Current issue
November-December 2023
Volume 43 | Issue 6
Page Nos. 245-296
Online since Wednesday, November 1, 2023
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REVIEW ARTICLE
A narrative review for clinical applications of magic
p. 245
Xiang-Chi Wu, Horng-Ta Tseng, Yi-Wen Lin, Chien-Sung Tsai, Feng-Yen Lin
DOI
:10.4103/jmedsci.jmedsci_147_22
Magic is an art form that has been traced back 1000 years ago. Previous studies have been conducted to investigate the positive effects magic could bring on human beings. Herein, we organize studies on the positive effects and the use of magic tricks in aspects of performing, witnessing, discovering the secrets of magic, and finally, in educational settings. We discovered that magic not only benefits well-being with physical and mental improvement but also works well as a therapeutic use for hospitals, pediatric settings, and rehabilitation for patients with functional loss. With research on the human mind developing rapidly, magic could also be a great study tool for exploring human cognition and perception. We conclude that magic has already brought about a great number of promising effects in various settings. Therefore, in this manuscript, we discuss how performing and perceiving magic tricks could bring positive effects on researchers and human beings.
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ORIGINAL ARTICLES
Factors associated with the use of electronic cigarettes among youths
p. 252
Thaniya Klinsophon, Premtip Thaveeratitham, Pooriput Waongenngarm
DOI
:10.4103/jmedsci.jmedsci_93_23
Background:
Electronic cigarettes (e-cigarettes) are rapidly becoming a popular new trend among youths and adolescents. However, there is little information available about the causes of e-cigarette use in youths, especially the mental, belief/attitude, and marketing factors that lead to e-cigarette usage.
Aim:
This study aimed to evaluate the factors associated with e-cigarette use among youths.
Methods:
We conducted a cross-sectional study of 1164 youths, administering a self-report questionnaire relating to the risk factors for e-cigarette usage: individual, family and friends, mental, belief/attitude, and marketing factors. We used logistic regression analysis to examine the factors and their association with e-cigarette use.
Results:
The prevalence of current e-cigarette use was 10.6%, while 19.4% of participants had used e-cigarettes at some time in their lives. History of drug use and attitudes about e-cigarette use (e-cigarettes are not harmful to health, using e-cigarettes can help stop smoking, and e-cigarettes help people improve social skills) were significantly associated with the current use of e-cigarettes. GPAX was a protective factor against current e-cigarette use.
Conclusion:
E-cigarette use is relatively high among youths. We discovered erroneous beliefs and attitudes (misunderstanding or disinformation regarding the harmful effects of e-cigarette use). Interventions to enhance knowledge about e-cigarettes are required for youths to reduce current e-cigarette use.
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Extracorporeal shockwave therapy on spasticity after central nervous system injury: A systemic review and meta-analysis
p. 258
Po-Huang Chen, Ching-Liang Ho, Cho-Hao Lee
DOI
:10.4103/jmedsci.jmedsci_239_22
Background:
Spasticity is a disorder characterized by velocity dependently increasing in the tonic stretch reflexes (muscle tone). There were variable managements for spasticity. Treatment of spasticity depends on the severity, involved part, and patient's and families' preference. However, there were more trials completed in studying the efficacy of extracorporeal shockwave therapy (ESWT) in treating spasticity in different disease.
Aim:
The goal of our study is to evaluate the efficacy of ESWT in treating of spasticity after central nervous system lesions and to analyze the influences of related factors; we performed a systemic review to survey the effect.
Methods:
We performed a thoroughly systematic review and meta-analysis.
Results:
Totally 9 studies were included 4 studies examined the spasticity in stroke group, 4 studies were in cerebral palsy, and 1 study in multiple sclerosis. Regarding the effect of spasticity reduction in overall populations, the pooled effect showed that the modified Ashworth scale grade reduction compared with the baseline values were standardized mean difference (SMD): −4.07 (95% confidence interval (CI), −5.37– −2.76;
P
< 0.001) immediately after ESWT, SMD: −2.51 (95% CI, −3.40– −1.62;
P
< 0.001) after 4 weeks, and SMD: −1.44 (95% CI, −1.92– −0.95;
P
< 0.001) after 12 weeks. In terms of the disease types, the SMD in stroke patients was SMD: −4.03 (95% CI, −5.44– −2.61;
Z
= 5.57;
P
< 0.001) immediately after ESWT, SMD: −2.34 (95% CI, −3.01– −1.66;
Z
= 6.80;
P
< 0.001) after 4 weeks and SMD: −1.50 (95% CI, −2.06– −0.93;
Z
= 5.20;
P
< 0.001) after 12 weeks. No significant adverse events were found.
Conclusion:
The present meta-analysis revealed that ESWT effectively alleviates spasticity in patients after upper motor neuron lesions, regardless of disease type and parts treated. Both radial and focus ESWTs could decrease spasticity, regardless of the treatment session. The result could last for 12 weeks after treatment. Moreover, no serious side effects were observed after ESWT. Further studies with randomization and more parameters of ESWT were advised to setup to improve the clinical effectiveness.
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A simple method for calculating acetabular posterior wall fracture fragment percentages on three-dimensional computed tomography scan reconstruction images
p. 269
Chun-Liang Hsu, Jia-Lin Wu, Yao-Tung Tsai, Chun-Chi Hung, Yuan-Ta Li, Tsu-Te Yeh
DOI
:10.4103/jmedsci.jmedsci_244_22
Background:
Hip joint congruency and stability in fractures are affected by posterior wall fragment size and percentage compared with the normal side. Computed tomography (CT) scan is a useful tool to precisely evaluate the morphologic features of acetabular fractures.
Aim
: The aim of this study was to establish an accurate and reliable method of measuring acetabular posterior wall fracture fragment percentages on three-dimensional (3D) CT scan reconstruction images.
Methods
: CT scans of eight patients with acetabular posterior wall fractures were reviewed by five orthopedic surgeons. Posterior wall fracture fragment percentages were measured using three methods: (1) linear measurement percentages on axial CT images, (2) linear measurement percentages on 3D reconstruction images, and (3) acetabular posterior surface area measurements using computer software (gold standard). Analysis of variance testing was used to compare these methods. Dunn's multiple comparison test was used to compare the accuracy of the axial CT scan and 3D reconstruction methods to the gold standard method.
Results
: There were no significant differences between two of the eight patients (25%) in fracture fragment percentage measurements using all methods. Dunn's multiple comparison test showed that the axial CT scan method measurement was significantly different from the gold standard measurement in four of the eight patients (50%), three of whom sustained more than an 80% fracture. However, there was no significant difference between the 3D reconstruction and gold standard methods in all study patients. Inter- and intra-observer reliabilities were excellent for all three methods.
Conclusion
: The 3D reconstruction image method is reliable and accurate for measuring acetabular posterior wall fracture fragment percentages.
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Increased cerebral blood flow following L110 acupuncture in healthy volunteers observed with
99m
Tc-ethyl cysteine dimer single-photon emission computed tomography
p. 276
Skye Hsin-Hsien Yeh, Ching-Heng Lin, Ping-Ying Chang, Li-Fan Lin, Shin-En Tang, Chuang-Hsin Chiu
DOI
:10.4103/jmedsci.jmedsci_256_22
Background:
Ischemic stroke is the second most common cause of death and a major cause of disability worldwide. Acupuncture is frequently advocated as an alternative treatment during stroke rehabilitation.
Aim:
The purpose of this study was to measure regional cerebral blood flow (rCBF) following acupuncture at LI-10 Shousanli in healthy volunteers using
99m
Tc-ethyl cysteine dimer (
99m
Tc-ECD) single-photon emission computed tomography (SPECT).
Methods:
Fourteen healthy volunteers were enrolled in this study. A baseline brain SPECT was taken, and 3 months later, acupuncture was performed at LI-10 for 20 min, followed by a second SPECT. Statistical parametric mapping was used to analyze the changes in rCBF before and after acupuncture through a paired t-test.
Results:
Perfusion increased in the caudate, thalamus, hippocampus, and precuneus (
P
< 0.05) regions after acupuncture at LI-10 compared to baseline and decreased rCBF was observed in the frontal cortex, occipital cortex, and parietal regions compared to baseline. Differences between baseline and postacupuncture (PA) perfusion levels showed were highest in the hippocampus region, followed by the striatum, thalamus, and cerebellum regions.
Conclusion:
99m
TC-ECD SPECT revealed significant increases in rCBF for specific region PA at LI-10. These results provide reference control group data for future longitudinal studies of stroke patients receiving acupuncture therapy as an alternative treatment to improve motor function and aid intensive rehabilitation.
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CASE REPORTS
Hyperammonemic encephalopathy in
Staphylococcus aureus
necrotizing fasciitis
p. 283
Yi-Cheng Li, Yaw-Wen Chang
DOI
:10.4103/jmedsci.jmedsci_214_22
This study described a rare case of necrotizing fasciitis presenting as neural dysfunction. The patient's serum ammonia level was significantly elevated; however, no liver function impairment was observed. Hyperammonemia is frequently related to the liver's ammonia metabolism failure. In literature reviews, infections also induce critical complications in specific circumstances. Herein, a rare case of
Staphylococcus aureus
necrotizing fasciitis with a hyperammonemic encephalopathy presentation was offered.
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Esophageal schwannoma with unusual endoscopic ultrasound imaging findings
p. 285
Fu-Chieh Hsu, Tsai-Wang Huang
DOI
:10.4103/jmedsci.jmedsci_238_22
Esophageal schwannomas are a subset of rare tumors that are difficult to differentiate from other esophageal tumors preoperatively. On endoscopic ultrasound (EUS), esophageal schwannomas generally appear as well-demarcated masses that are heterogeneous, hypoechoic, or mixed-echogenic in nature. We present a case of esophageal schwannoma with atypical EUS findings. EUS revealed two lobulated tumors that originated from the muscularis propria and characterized by heterogeneous hypoechoic features and poor blood flow signals. Right-sided video-assisted thoracoscopic surgery with esophageal tumor enucleation was performed. Immunostaining finally confirmed the diagnosis of an esophageal schwannoma. Esophageal schwannomas tend to show heterogeneous hypoechoic or mixed-echogenic features, but they rarely present with two lobulated masses.
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Acute ischemic stroke with cortical blindness caused by inherited protein C deficiency
p. 288
Ching-Hao Yu, Yi Liu, Chih-Wei Wang, Fu-Chi Yang
DOI
:10.4103/jmedsci.jmedsci_240_22
Bilateral occipital lesions caused by bilateral posterior cerebral artery (PCA) blockage are rare and can present as cortical blindness, which is defined as loss of vision without any ophthalmological cause and retention of normal pupillary light reflexes. Inherited protein C (PC) deficiency may cause thromboembolism, which leads to stroke. We presented a 68-year-old man with bilateral hemianopia, and brain imaging revealed bilateral PCA territory infarcts. PC deficiency was identified, and the symptoms gradually resolved after aspirin and warfarin were administered. The patient's family members underwent laboratory examinations, and his daughter was found to have PC deficiency.
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Finding a needle in the haystack: A hidden follicular lymphoma
p. 292
Hung-Yu Lin, Yi-Jen Peng, Yi-Ying Wu, Ping-Ying Chang
DOI
:10.4103/jmedsci.jmedsci_249_22
The classical morphological features of follicular lymphoma (FL) are well-recognized. However, identifying some morphological variants, such as FL with hyaline-vascular Castleman disease (HVCD) like features (FL-HVCD), is challenging. Hence, we report a 57-year-old male with FL-HVCD who presented with nontender swelling of the bilateral lower limbs, caused by enlarged intra-abdominal lymph nodes with venous compression. The excised lymph nodes showed onionskin-like mantle zones and hyalinized blood vessels, which was consisted with HVCD. Oral medications were prescribed; however, the patient was lost to follow-up after 6 months and was readmitted with anemia, thrombocytopenia, and leukocytosis 3 years later. A bone marrow biopsy was done, and the patient was diagnosed as having overt FL with bone marrow involvement. Physicians should be careful if HCVD patients present with systemic symptoms or generalized lymphadenopathy. Excluding the possibility of lymphoma is necessary because the different treatment strategy and prognosis from HVCD.
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LETTER TO EDITOR
Refixation of labrum in pincer type of femoroacetabular impingement
p. 296
Jui-Yen Weng, Zhi-Hong Zheng
DOI
:10.4103/jmedsci.jmedsci_49_23
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