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.

Case Report: Exploratory treatment with multiple intravenous infusion of the autologous adipose tissue-derived mesenchymal stem cells for the treatment of Diamond-Blackfan anemia patient

Abstract: Diamond-Blackfan anemia (DBA) is a rare congenital erythropoietic disorder characterized by erythroblastopenia. Conventional treatments of DBA are the administrations of corticosteroids and blood transfusions for mitigation of anemia, and bone marrow transplantation. However, there are hurdles to overcome for long-term use and the conventional treatment. Mesenchymal stem cells (MSCs) have been noted as a novel alternative cell therapy in various diseases, and adipose tissue-derived MSCs (AdMSCs) are known for their versatile efficacies and feasibility. Here, we report the potential efficacies and the safety of intravenous administration of the autologous AdMSC in a patient with DBA for the first time. The isolation and characterization of autologous AdMSCs from a girl aged 11 years, 10 months with DBA were carried out due to the mutation of ribosomal protein s24 (RPS24). AdMSCs, diluted to 1 x 10 8 cells in 100 ml of saline, were infused intravenously for 1 hour. Intravenous administration of AdMSCs was carried out 5 times in 2-week intervals, and the patient was checked using various assessments (vital signs, physical examination, laboratory tests, adverse events, etc) at every visit. After 3, 6 and 9 months from the first administration of AdMSCs, red blood cell (RBC) count, hemoglobin value, and hematocrit were assessed for the efficacy. There were no side effects or adverse events observed during the treatment. Although showing subnormal values, the RBC number, hemoglobin level, and hematocrit were improved 9 months after the systemic administration of AdMSCs from baseline; the RBC count (x10 6 /μl), hemoglobin level (g/dl) and hematocrit level (%) were increased from 1.58 to 2.38, 5.6 to 8.3, and 16.9 to 26.1, respectively. The present case reported the first AdMSC administration for DBA patient and indicates it is possible that the intravenous administration of autologous AdMSC can be a safe alternative for DBA treatment.

Integrated Strategies for Enhancement of Fertility in PCOS

Abstract: Polycystic ovary syndrome (PCOS) is a common cause of anovulatory infertility; hence, ovulation induction is usually the first line of treatment for the majority. Prior to commencing ovulation induction, it is imperative to optimise any coexisting metabolic disorder, and the first line of treatment is lifestyle intervention. Pharmacological interventions consist of aromatase inhibitors, clomiphene citrate and metformin therapy, often combined with clomiphene in patients who are overweight. Subsequently intervention with gonadotrophins using a low-dose step-up protocol to minimise the risk of a multiple pregnancy is the next step. In the presence of normal pelvis at the time of laparoscopy, and in the absence of any impairment of the semen sample, it is reasonable to perform laparoscopic ovarian drilling. If these interventions are unsuccessful, or in the presence of other causes of infertility, such as a compromised semen sample, or fallopian tube compromise, in vitro fertilisation (IVF) is required. Patients with PCOS are ideally suited to the approach of in vitro oocyte maturation (IVM) to minimise their risk of ovarian hyperstimulation syndrome (OHSS). Other techniques to minimise the risk of this serious complication of IVF consist of the use of an antagonist rather than an agonist regime; the adjuvant use of metformin, adopting a ‘freeze-all’ approach after the use of an agonist trigger; and the administration of cabergoline to minimise the risk of severe OHSS.

Fever, Headache and Photophobia

Abstract: The complement system has three activation pathways: the classical pathway, the mannose pathway, and the alternate pathway

Turning green: the impact of changing to more eco-friendly respiratory healthcare. A carbon and cost analysis of Dutch prescription data.

Abstract: ObjectivesDry powder inhalers (DPIs) have a substantially lower global warming potential than pressurized metered-dose inhalers (MDIs). To help mitigate climate change, we assessed the potential reduction in CO2-equivalents when replacing MDIs by DPIs in the Netherlands, and estimated the associated cost. DesignWe performed a four-step analysis based on data from two national databases of two independent governmental bodies (Dutch National Healthcare Institute and the Dutch Healthcare Authority). First, we calculated the number of patients with Chronic Obstructive Pulmonary Disease (COPD) and asthma that were using inhalation medication (2020). Second, we calculated the number and total of daily defined doses of MDIs, DPIs, and soft mist inhalers and the number of spacers per patients, dispensed by non-hospital based pharmacies in 2020. Third, we estimated the potential reduction in CO2-equivalents (eq.) if all eligible patients ([≥]7 years old; COPD with [≤]1 exacerbation per year) would switch from using MDIs to using DPIs as eco-friendly alternatives. Fourth, we performed a cost-effectiveness analysis. ResultsIn 2020, 1.4 million patients used inhalers for COPD or asthma treatment. A total of 460 million defined daily doses (DDDs) from inhalers were dispensed, of which - after the exclusion of nebulisers - 50.4% were from MDIs. We estimated that this use could be reduced by 70% leading to annual reduction in emissions of 77 - 84 million kg CO2eq. saving at best EUR 49.8 million annually. ConclusionsIn the Netherlands, substitution of MDIs to DPIs for eligible patients is theoretically safe and in accordance with medical guidelines, while reducing emissions by 80 million kg.CO2eq. on average and saving at best EUR 49.8 million per year. This study confirms the potential climate and economic benefit of delivering eco-friendlier respiratory care. Strengths and limitations of this studyO_LIGiven availability and reliability of the data, the present analysis can easily be replicated elsewhere which allows for international comparison and aggregation. C_LIO_LIImplementation challenges remain underexposed. C_LI