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.

The Accuracy of Increased Blood Concentration of Prostate-Specific Antigen to Prostate Malignancy

Abstract: Background: Various controversies arose in the study of PSA examination as an alternative of biopsy to detect prostate malignancy. Prostate Specific Antigen (PSA) is a specific protein secreted by the prostate gland and is affected by various conditions. PSA levels will certainly increase at the enlargement of the prostate gland. An accurate cutoff point that can detect prostate cancer is needed. Objective: To evaluate the PSA diagnostic test against prostate malignancy. Methods: This study used a diagnostic test method for 91 patients undergoing either prostate gland surgery or open prostatectomy at Bethesda Hospital Yogyakarta in January 2014-January 2016 period. Data were taken from medical records with inclusion criteria as follow: over 50 years of age, preoperative PSA, and PA results. This study was a descriptive analytic study. In the diagnostic test AuROC, cutoff points were determined. Chisquare test was performed to assess sensitivity, specificity, PPV, NPV, LHR -, and LHR +. Results: We studied 91 patients with a mean age of 70.24 ( 46-54 ) and mean PSA level of 27.2 ( 0.59-101 ). The results of PA prostate tissue examinations were adenocarcinoma in 15 patients ( 16.5 % ) and BPH in 76 patients ( 83.5 %) On all PSA levels, AuROC were 0.90. Specificity of PSA with 4 ng / mL cutoff, 10 ng / mL, 20 ng / mL, 50 ng / mL, and 100 ng / mL were 0.53, 35.53, 67.11, 96.05, 98.68. When the cutoffs were reduced to 4.01-10ng/mL, 10.01-20 ng/mL, 20.01-50ng/ mL,50.01-100 ng/mL, and > 100 ng/mL, the specifity were 76.32, 68.00, 69.74, 96.05, 100.00. Cutoff value of 50ng / mL had LHR + >10.00 ( 15:20 ). Conclusion: There is a strong correlation between PSA and prostate malignancy. PSA value> 50 ng / mL has high accuracy to detect prostate malignancy. A biopsy is needed to determine a definitive diagnostic because no cutoff value can be used as a benchmark.

Broad Thumbs and Toes with Mental Retardation; Syndrome of Rubinstein and Taybi

Abstract: Seeing the unusual syndrome in an Indonesian baby we considered publication worthwhile. The Rubinstein and Taybi syndro- me consists of a large number of congenital anomalies. Some of these are common to all cases, many are seen in some cases only.

A Unique Case of Pyruvate Carboxylase Deficiency.

Abstract: Pyruvate carboxylase (PC) converts pyruvate to oxaloacetate, which is an important step in gluconeogenesis. Pyruvate carboxylase deficiency (PCD) is a rare inherited metabolic disorder characterized by movement disorders, neurologic disturbances, hypoglycemia, lactic acidosis, hyperammonemia, and elevated levels of pyruvate and alanine in plasma. The prognosis for PCD is poor. Most children die within the first six months of life, and those who survive longer have neurological damage and mental disability. This is due to the accumulation of lactic acid and toxic components in the blood. Here we describe the case of a 21-month-old male presenting with abnormal movements and new-onset seizures. His family history is relevant because of parental consanguinity. A genetic analysis showed a novel mutation, homozygous c. 2630A>G (p. Gln877Arg) variant, in the PC gene, a mutation not previously described in the English literature.

Evaluation of a shared decision-making strategy with online decision aids in surgical and orthopaedic practice: study protocol for the E-valuAID, a multicentre study with a stepped-wedge design.

Abstract: Inguinal hernia repair, gallbladder removal, and knee- and hip replacements are the most commonly performed surgical procedures, but all are subject to practice variation and variable patient-reported outcomes. Shared decision-making (SDM) has the potential to reduce surgery rates and increase patient satisfaction. This study aims to evaluate the effectiveness of an SDM strategy with online decision aids for surgical and orthopaedic practice in terms of impact on surgery rates, patient-reported outcomes, and cost-effectiveness. The E-valuAID-study is designed as a multicentre, non-randomized stepped-wedge study in patients with an inguinal hernia, gallstones, knee or hip osteoarthritis in six surgical and six orthopaedic departments. The primary outcome is the surgery rate before and after implementation of the SDM strategy. Secondary outcomes are patient-reported outcomes and cost-effectiveness. Patients in the usual care cluster prior to implementation of the SDM strategy will be treated in accordance with the best available clinical evidence, physician’s knowledge and preference and the patient’s preference. The intervention consists of the implementation of the SDM strategy and provision of disease-specific online decision aids. Decision aids will be provided to the patients before the consultation in which treatment decision is made. During this consultation, treatment preferences are discussed, and the final treatment decision is confirmed. Surgery rates will be extracted from hospital files. Secondary outcomes will be evaluated using questionnaires, at baseline, 3 and 6 months. The E-valuAID-study will examine the cost-effectiveness of an SDM strategy with online decision aids in patients with an inguinal hernia, gallstones, knee or hip osteoarthritis. This study will show whether decision aids reduce operation rates while improving patient-reported outcomes. We hypothesize that the SDM strategy will lead to lower surgery rates, better patient-reported outcomes, and be cost-effective. Trial registration: The Netherlands Trial Register, Trial NL8318, registered 22 January 2020. URL: https://www.trialregister.nl/trial/8318 .