Gout is the most common inflammatory arthritis among Filipinos, characterized by hyperuricemia leading to mono- sodium urate crystal deposition and an ensuing inflammatory response. Though typically a disorder of middle- aged and older adults, tophaceous gout presenting before the age of 30 is rare and suggests aggressive disease progression. Allopurinol, a first-line urate-lowering therapy, is generally effective but may cause rare, potentially life-threatening adverse reactions such as allopurinol hypersensitivity syndrome (AHS). Febuxostat, a non-purine xanthine oxidase inhibitor, is an alternative for patients intolerant to allopurinol. Although hypersensitivity reactions to febuxostat are extremely rare, isolated case reports document their occurrence in both patients with prior AHS and in allopurinol-naïve individuals. Hypersensitivity to both agents is exceedingly uncommon and presents a major therapeutic challenge. In such cases, febuxostat desensitization, conducted in collaboration with allergy specialists, may permit a viable solution to safely reintroduce urate-lowering therapy and prevent further disease progression. This case report describes a patient with young-onset, tophaceous gout who developed severe hypersensitivity reactions to both allopurinol and febuxostat — an unusual and challenging therapeutic dilemma. The case highlights the need for individualized management strategies, including the consideration of drug desensitization, in patients with limited urate-lowering options.

Human ; Male ; Adult: 25-44 Yrs Old ; World Health Organization ; Therapeutics ; Specialization ; Solutions ; Research Report ; Pharmaceutical Preparations

Diffuse infiltrating retinoblastoma is an extremely rare form of retinoblastoma which is characterized by its atypical growth pattern. This unusual presentation adds complexity to the diagnostic process. The purpose of this paper is to report a rare presentation of diffuse infiltrating retinoblastoma presenting after an ocular trauma. We described a 7-year-old Filipino boy presenting with total hyphema following an ocular trauma. Comprehensive ophthalmologic clinical and diagnostic evaluations were performed including visual acuity, slitlamp biomicroscopy, ocular ultrasound, neuroimaging, and histopathology post enucleation to determine diagnosis. The misleading, atypical presentation of diffuse infiltrating retinoblastoma may delay diagnosis. While this dilemma is expected in these scenarios, it should be remembered that timing of diagnosis in retinoblastoma is crucial, as this also equates to optimal management. One should remain vigilant for these uncommon presentations especially in the setting of any intraocular inflammation in children.

Human ; Male ; Child: 6-12 Yrs Old ; Wounds And Injuries ; Visual Acuity ; Retinoblastoma ; Research Report ; Neuroimaging ; Inflammation ; Hyphema ; Contusions

Human ; Writing ; Artificial Intelligence

During the period of the Republic of China, acupuncture faced different opportunities and developments in China and the West. The correspondence between Soulié de Morant, the father of European acupuncture, and FANG Shen'an, a famous acupuncture master of the Republic of China, is of great significance to explore the exchange of acupuncture between China and France, the development of acupuncture in France, the Western learning of Chinese medicine, and the dissemination of academic ideas of acupuncture in the Republic of China. The authors studied Soulié de Morant's collection stored in the Museum of Western Studies of Chinese Medicine of Yunnan University of Chinese Medicine, and found Soulié de Morant's annotation of Jinzhen Mizhuan (Secrets of Golden Needle), the 1937 edition, and 3 paper letters with FANG Shen'an (2 letters in French and 1 letter in Chinese). After the language translation and collation, based on the correspondence between two masters, in association with the historical background and the narration of CHEN Yemeng, the inheritor of Fang's acupuncture, this paper reviews the process of academic exchanges between them, so as to display the historical development of acupuncture in China and the West.
China ; History, 20th Century ; Acupuncture/education* ; Humans ; Acupuncture Therapy/history* ; France ; Correspondence as Topic/history*

BACKGROUND: Adolescence was associated with suboptimal diabetes control. Studies supporting the use of mobile technology to improve glycemic control and adherence to treatment had mixed results.

OBJECTIVES: This study aimed to evaluate the effect of SMS reminders on improving glycemic control in adolescents with Type 1 Diabetes Mellitus (T1DM)

METHODOLOGY: A randomized control study among adolescents with poorly controlled type 1 diabetes mellitus was done. Data were processed from 56 out of 64 subjects who were randomized into control (N=29) who received standard of care and SMS group (N=27), who received standard of care and a daily SMS reminder regarding diabetes self-care for 12 weeks. An adherence form was answered by all participants and glycosylated hemoglobin (HbA1c) before and after intervention was compared.

RESULTS: HbA1c did not significantly differ between SMS and control groups after 12 weeks of intervention (SMS 9.98+2.12 vs control 10.54+2.13, p value of 0.305). Post intervention, there was no significant difference between SMS and control group in terms of adherence to insulin injection (no p value), blood glucose (BG) monitoring (p value 0.106), and diabetic diet (p value 0.803). However, adherence on exercise was significantly higher among control group than SMS group (p value 0.003).

CONCLUSION: A 12-week SMS intervention reminder in adolescents with type 1 diabetes mellitus did not significantly improve glycemic control and adherence to standard of care (insulin injection, blood glucose monitoring, diet and exercise).

RECOMMENDATION: Future researches could include a bigger study population and longer duration of intervention. Other forms of mobile technology could also be used as a form of reminder.

Human ; Male ; Female ; Child: 6-12 Yrs Old ; Adolescent: 13-18 Yrs Old ; Diabetes Mellitus ; Diabetes Mellitus, Type 1 ; Text Messaging ; Glycated Hemoglobin ; Therapeutics ; Technology ; Standard Of Care ; Self Care

text-align: justify;" data-mce-style="text-align: justify;">Case reports remain to be an essential part of knowledge generation in health care. It is a research design that involves writing about a patient’s illness with either an unusual, new, unexpected, or unique characteristic. It can be about new findings, a novel diagnostic test, unfamiliar adverse events or innovative medical and surgical interventions. It is a detailed description of a patient’s course of illness including symptoms, physical examination findings, laboratory results, treatment modalities and outcomes. The essential element of writing a case report or series is to contribute to the generation of new knowledge. Wellwritten manuscripts have a valuable purpose in medicine as they present new illness, unexpected effects of treatment, novel diagnostic exams or unforeseen patients’ outcomes. The sections of a case report include an Abstract, Introduction or Background, Case Presentation [history, physical examinations, investigations or laboratories, differential diagnosis (if relevant), treatment (if relevant), outcome/follow-up, Discussion, Learning points/Take home messages, Patients perspectives and References. Manuscripts written as case reports or case series by nature of their design are not required to get approval from an Ethics Review Board (ERB). However, there should be an institutional process to clear and register papers. Case reports or a case series has its own distinctive writing components and features as not all single or series of clinical cases are reportable. This article aimed to define case reports/series, describe the different parts, how to write and evaluate a case report manuscript using the CARE guidelines.

Case Reports ; Writing

text-align: justify;" data-mce-style="text-align: justify;">Conducting and writing quality improvement studies is a skill that every family and community physician should learn and apply in their practice. As family and community physicians it is one of our responsibilities to provide quality health care to our patients.1 Simply put, “quality” is doing the right thing right the first time and doing it better the next. Similar to the doctor-patient interaction in a typical consult, where the physician’s objective is to learn as much as possible about the patient’s signs and symptoms and medical history in order to make the right diagnosis and thus render the right treatment. The physician strives to do all this on the first visit and hopes to keep up-to-date on the condition so that when another patient presents with the same condition, he or she will receive better and more current care.

Human ; Quality Improvement ; Writing

The number of studies related to health economics evaluation is increasing. Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022) contains 28 items. Based on CHEERS 2013, CHEERS 2022 adds a health economic analysis plan, model sharing, and community, patient, public, and other relevant stakeholders' participation in the statement, taking into account the future development direction of health economics evaluation. It provides a useful review tool for peer reviewers, editors, and readers and supports health technology assessment agencies in establishing standard reporting standards for health economics evaluations. In this study, we briefly introduced and interpreted the CHEERS 2022 statement and analyzed an example of health economics evaluation in infectious disease epidemiology to provide a reference for researchers to report studies regarding health economics evaluation standardly.
Humans ; Cost-Benefit Analysis ; Checklist ; Economics, Medical ; Reference Standards ; Research Report

OBJECTIVE: To assess the methodological quality, report quality and evidence quality of the Meta-analysis and systematic reviews of acupuncture and moxibustion for children with cerebral palsy, aiming to provide decision-making basis for clinical treatment. METHODS: The systematic reviews and Meta-analysis of acupuncture and moxibustion for children with cerebral palsy were searched in CNKI, Wanfang, VIP, SinoMed, Cochrane Library, PubMed and EMbase. The retrieval time was from the database establishment to June 30th, 2022. AMSTAR 2 (a measurement tool to assess systematic reviews) was used to evaluate the methodological quality， and PRISMA (preferred reporting items for systematic reviews and Meta-analyses) was used to evaluate the report quality, and GRADE was used to evaluate the quality of evidence. RESULTS: A total of 14 systematic reviews were included, including 37 primary outcome indexes. According to AMSTAR 2 evaluation results, there were 4 low quality studies, 10 very low quality studies, and low scores on items 2, 4, 7, 10 and 16. PRISMA scores ranged from 15 to 25, and the main reporting problems reflected in structured abstracts, program and registration, retrieval, and funding sources, etc. According to the GRADE classification results, there were 3 high quality evidences, 7 medium quality evidences, 10 low quality evidences and 17 very low quality evidences. The main downgrading factors were limitations, imprecision and publication bias. CONCLUSION Acupuncture and moxibustion has a certain effect for cerebral palsy in children, but the quality of methodology, reporting and evidence in the included literature is poor, and the comparison of curative effect between different acupuncture and moxibustion methods is unclear.
Child ; Humans ; Acupuncture Therapy/methods* ; Cerebral Palsy/therapy* ; Moxibustion/methods* ; Publication Bias ; Research Report ; Systematic Reviews as Topic ; Meta-Analysis as Topic

Reference Standards ; Writing