Bethesda Hospital

About: Bethesda Hospital is a healthcare organization based out in Ambur, Tamil Nadu, India. It is known for research contribution in the topics: Population & Helicobacter pylori. The organization has 386 authors who have published 472 publications receiving 15193 citations.

Esophageal squamous cell carcinoma presenting with extensive skin lesions: a case report

Abstract: Esophageal squamous cell carcinoma (ESCC) is the most common histological subtype of cancer in the upper and middle esophagus and is characterized by a high rate of mortality. The incidence of esophageal cancer varies greatly among regions of the world and occurs at a high frequency in Asia and South America. In our department, a 51-year-old man was diagnosed with ESCC after presenting with extensive disseminated skin nodules. Biopsy of the nodules showed metastatic ESCC. Cutaneous manifestations of esophageal neoplasia are very rare and are mainly described for esophageal adenocarcinoma (EADC). Here we report a very uncommon case of extensive skin metastases of ESCC. Early biopsies of suspicious skin lesions are important and should be performed in patients with unclear symptoms such as weight loss or dysphagia and especially in patients with a history of cancer, since they can reveal the existence of a distant malignant disease leading to diagnosis and prompt therapy.

Evaluation of an oral uracil loading test to identify DPD-deficient patients using a limited sampling strategy

Abstract: AIM Dihydropyrimidine dehydrogenase (DPD) deficiency can lead to severe toxicity following 5-fluorouracil (5FU) or capecitabine (CAP) treatment Uracil (U) can be used as a probe to determine systemic DPD activity The present study was performed to assess the sensitivity and specificity of a U loading dose for detecting DPD deficiency METHODS Cancer patients with Common Toxicity Score (CTC) grade III or IV toxicity after the first or second cycle of 5-FU or CAP treatment were asked to participate Based on DPD activity in PBMCs, patients were divided into two groups: DPD activity in peripheral blood mononuclear cells (PBMCs) <5 nmol mg(-1) *h(-1) (deficient group) and ≥ 5 nmol mg(-1) *h(-1) U 500 mg m(-2) was administered orally and plasma concentrations of U and dihydrouracil (DHU) were determined In the deficient group, polymerase chain reaction amplification of all 23 coding exons and flanking intronic regions of DPYD was performed A U pharmacokinetic model was developed and used to determine the maximum enzymatic conversion capacity (Vmax ) of the DPD enzyme for each patient The sensitivity and specificity of Vmax, U concentration and the U/DHU concentration ratio were determined RESULTS A total of 47 patients were included (19 DPD deficient, 28 DPD normal) Of the pharmacokinetic parameters investigated, a sensitivity and specificity of 80% and 98%, respectively, was obtained for the U/DHU ratio at t = 120 min CONCLUSIONS The high sensitivity of the U/DHU ratio at t = 120 min for detecting DPD deficiency, as defined by DPD activity in PBMCs, showed that the oral U loading dose can effectively identify patients with reduced DPD activity

A controlled clinical study on the new topical dosage form of DHEP plasters in patients suffering from localized inflammatory diseases

Abstract: In this clinical study the efficacy and the tolerability of a new topical formulation, DHEP plaster, have been evaluated. The plaster consists of an auto-adhesive medicated gauze pad of standard dimensions(10×15 cm) containing 180 mg DHEP. The reference drug was a well-known topical drug, diclofenac diethylammnonium (DDA) emulgel at 1.16%. Treatments were applied to the affected area for 14 ddays: DHEP plaster b.i.d. and DDA emulgel q.i.d. A total of 190 patients, affected by various inflammatory diseases, participated in this clinical study

Opening-wedge high tibial osteotomy with a locked low-profile plate: surgical technique.

Abstract: BACKGROUND: High tibial osteotomy has been recognized as a beneficial treatment for osteoarthritis of the medial compartment of the knee. The purpose of this prospective study was to assess the short-term results of opening-wedge high tibial osteotomies with locked plate fixation. METHODS: From September 2002 to November 2005, fifty-one consecutive medial opening-wedge high tibial osteotomies were performed. The mean age of the patients at the time of the index operation was forty-nine years. The preoperative and postoperative factors analyzed included the grade of arthritis of the tibiofemoral compartment (the Ahlback radiographic grade), the anatomic tibiofemoral angle, patellar height, the Hospital for Special Surgery rating system score, and the Lysholm and Gillquist knee score. RESULTS: Postoperatively, one superficial wound infection occurred. Fifty of the fifty-one osteotomies healed after an average period of 12.9 weeks (range, eight to sixteen weeks) without bone grafts. A nonunion developed in a sixty-two-year-old patient who was a cigarette smoker. The average postoperative tibiofemoral angle was 9° of valgus. Forty-nine patients were followed for a mean of fifty-two months. The average score on the Hospital for Special Surgery rating system was 86 points at the time of the most recent follow-up. The rating was excellent in twenty-eight patients (57%), good in twelve (24%), fair in four (8%), and poor in five (10%). The average score on the Lysholm and Gillquist knee-scoring scale was 83 points. According to these scores, the outcome was excellent in nine patients (18%), good in thirty-one (63%), fair in three (6%), and poor in six (12%). Four knees failed after an average of thirty-six months. CONCLUSIONS: Our results suggest that an opening-wedge high tibial osteotomy with locked plate fixation allows a correct valgus angle to be achieved with good short-term results. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence. ORIGINAL ABSTRACT CITATION: “Opening-Wedge High Tibial Osteotomy with a Locked Low-Profile Plate” (2009;91:2581-8).

Incoordination in pianists with overuse syndrome

Abstract: To investigate claims that painful musculoligamentous overuse in the arms and hands of pianists is accompanied by loss of motor control, we studied 18 pianists with overuse syndrome of one or both arms and hands and 22 skill-matched pianists with no history of overuse. All of the pianists performed continuous repetitions of a five-finger exercise on a piano keyboard at metronome-paced tempos. The main outcome measures were quantitative analysis of four measurements of performance (duration of key presses, interval between key presses, velocity of key presses [loudness], and time off the metronome beat [difference between actual and expected time of key press]); comparison of the errors in the two groups; and comparison of the performances by a listening panel. The two groups had significant differences in performance, and a classification tree had a sensitivity of 0.886 and a specificity of 0.862 in identifying the affected hands. The pianists with overuse syndrome made more skill-based errors. The listening panel could distinguish between the affected and unaffected hands. We conclude that pianists with overuse syndrome have a coordination disturbance.