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.

Total Versus Near-total Thyroidectomy in Graves Disease: Results of the Randomized Controlled Multicenter TONIG-trial.

Abstract: Background:Previous data suggest that the incidence of hypoparathyroidism after surgery for Graves disease (GD) is lower after subtotal thyroidectomy compared to total thyroidectomy (TT). The present study evaluated the incidence of postoperative hypoparathyroidism after near-total (NTT) versus TT i

The Effect of Dialysate Flow Rate on Dialysis Adequacy and Fatigue in Hemodialysis Patients

Abstract: Purpose: In this single repeated measures study, an examination was done on the effects of dialysate flow rate on dialysis adequacy and fatigue in patients receiving hemodialysis. Methods: This study was a prospective single center study in which repeated measures analysis of variance were used to compare Kt/V urea (Kt/V) and urea reduction ratio (URR) as dialysis adequacy measures and level of fatigue at different dialysate flow rates: twice as fast as the participant’s own blood flow, 500 mL/min, and 700 mL/min. Thirty-seven hemodialysis patients received all three dialysate flow rates using counterbalancing. Results: The Kt/V (M±SD) was 1.40±0.25 at twice the blood flow rate, 1.41±0.23 at 500 mL/min, and 1.46±0.24 at 700 mL/min. The URR (M±SD) was 68.20±5.90 at twice the blood flow rate, 68.67±5.22 at 500 mL/min, and 70.11±5.13 at 700 mL/min. When dialysate flow rate was increased from twice the blood flow rate to 700 mL/min and from 500 mL/min to 700 mL/min, Kt/V and URR showed relative gains. There was no difference in fatigue according to dialysate flow rate. Conclusion: Increasing the dialysate flow rate to 700 mL/min is associated with a significant nicrease in dialysis adequacy. Hemodialysis with a dialysate flow rate of 700 mL/min should be considered in selected patients not achieving adequacy despite extended treatment times and optimized blood flow rate.

Extensive hepatic replacement due to liver metastases has no effect on 5-fluorouracil pharmacokinetics.

Abstract: Purpose. The influence of liver metastases on the pharmacokinetics of 5-fluorouracil (5-FU) and its metabolite 5,6-dihydrofluorouracil (DHFU) was studied in patients with liver metastases from gastrointestinal cancer (n=16) and compared with a control group of patients with nonmetastatic gastrointestinal cancer (n=18). Methods. Patients were assigned to two different groups based on the presence of liver metastases. The percentage of hepatic replacement was determined with CT and ultrasonography and classified as 50% of the total liver volume. Chemotherapy consisted of leucovorin 20 mg/m2 per day plus 5-FU 425 mg/m2 per day, both for 5 days. Blood sampling was carried out on the first day of the first chemotherapy cycle. 5-FU and DHFU were quantified in plasma by HPLC. A four-compartment parent drug-metabolite model with nonlinear Michaelis-Menten elimination from the central compartment of the parent drug (5-FU) was applied to describe 5-FU and DHFU pharmacokinetics. Results. No effect of liver metastases on 5-FU clearance was observed. The effects of 18 covariables on pharmacokinetic parameters were also studied in a univariate correlation analysis. Body surface area was positively correlated with the distribution volume of 5-FU in the central compartment and with Vmax (r=0.65 and r=0.54, respectively). Conclusions. There is no need for dose adjustment of 5-FU as a standard procedure in patients with liver metastases and mild to moderate elevations in liver function tests.

Closed depressed skull fracture in childhood reduced with suction cup method: case report.

Abstract: A closed depressed skull fracture in a child was reduced with a suction cup. This method keeps the fracture closed and leaves no scar.