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.

Neurodegenerative and psychiatric overlap in frontotemporal lobar degeneration: a case of familial frontotemporal dementia presenting with catatonia

Abstract: The behavioral variant of frontotemporal dementia (FTD) begins with psychiatric symptoms, including changes in personal conduct and/or interpersonal behavior. Prior to developing cognitive impairment, differentiating FTD from primary psychiatric disorders, like schizophrenia, can be challenging. This paper presents a case of traumatic brain injury with subsequent depression and catatonia. Initial response to electroconvulsive therapy and lorazepam suggested primarily psychiatric pathology. Subsequent symptom progression, reduced treatment response, and detailed family history evaluation led to the diagnosis of familial FTD with C9ORF72 mutation. This case highlights that familial FTD can present with depression with suicidal tendencies and catatonia, and that the responsiveness of these behavioral manifestations to standard therapies can change over time.

Teaching Heuristics and Mnemonics to Improve Generation of Differential Diagnoses

Abstract: Background: Differential diagnosis (DDx) is one of the key cognitive skills that medical learners must develop. However, little is known regarding the best methods for teaching DDx skills. As metac...

Knuckle pads - a rare finding.

Abstract: Knuckle pads are rare harmless subcutaneous nodules that must be differentiated from joint disease of the proximal interphalangeal or rarely of the metacarpophalangeal joints as well as from other masses of the paraarticular tissues. We present a case of an otherwise healthy 36-year-old woman presenting with bilateral knuckle pads located at the dorsal aspect of the proximal interphalangeal joints. No predisposition to a specific musculoskeletal disorder was noted. Ultrasound revealed well-delimited subcutaneous hypoechoic masses without internal flow signals at color Doppler. Histology showed proliferation of myofibroblasts with a decrease of elastic filaments in the deep dermis. The clinical picture, the family history in addition to the histology allowed us to make the diagnosis of knuckle pads. We present the ultrasound findings of knuckle pads and discuss the differential diagnosis of a "swelling" in the dorsal region of proximal interphalangeal joints and metacarpophalangeal joints.

Judgmental questions processed by a drug information center

Abstract: The number of judgmental questions handled by a pharmacy-operated, university-based drug information center was studied. Judgmental questions were defined as those requiring the integration of data or knowledge and experience in the process of making a decision regarding a specific therapeutic problem. Less than 5% of 720 questions handled by the drug information center during a three-month period were of the judgmental type. Based on this result, and because of the need to use resources most efficiently, it is suggested that it may be advisable to develop more regional (and fewer hospital) drug information centers.

Age at symptom onset in ankylosing spondylitis: is there a gender difference?

Abstract: The impact of human leukocyte antigen (HLA)-B27 on the age at disease onset in patients with ankylosing spondylitis (AS) has consistently been shown in several cohorts.1–4 A potential gender difference with respect to age at symptom onset remains, however, controversial5–8 as the distribution of HLA-B27 within these populations is not known in all studies. While no sex differences with regard to disease onset were found in several cohorts from Europe,5 ,6 a later disease onset in men was reported in a North American investigation.7 We analysed this issue within the ongoing Swiss Clinical Quality Management cohort of patients with axial spondyloarthritis (axSpA).9 Ethics approval was given by the regional review boards. Informed consent was obtained from all patients. From a total of 3046 spondyloarthritis patients recruited until June 2014, 2098 (1294 men, 804 women) were included in this analysis, as they fulfilled the Assessment in SpondyloArthritis International Society (ASAS) classification criteria, with the following minor modifications, as the cohort was initiated before the publication of these criteria.9 First, …