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.

Is It Safe to Perform Lung Surgery During the Coronavirus Pandemic

Abstract: Background Coronavirus disease (COVID-19) patients are rapidly growing in our community. Patients with compromised lungs and older age are supposedly at high risk of poor outcomes with COVID-19. We aimed to evaluate the COVID-19 impact on lung surgery during this pandemic at our hospital. Methodology This is a retrospective study of all lung surgery patients at our hospital in Boca Raton over three months (February to April 2020). All patients who remained for at least one-day inpatient post-lung surgery were assessed to see if they had an increased incidence of coronavirus infection during the hospital stay or at the follow-up office visit. Results A total of 44 patients underwent thoracic surgery. It was found that there was no incidence of coronavirus infection in these patients. Conclusion With adequate precautions, older patients can undergo lung surgery during this pandemic. There was no incidence of COVID-19 found among the patients during the hospital stay or at the first follow-up in the office. Also, the postoperative course was not adversely affected.

Effectiveness and Safety of Switching Rapid-Acting Insulins to Insulin Glulisine in Patients with Diabetes: The Observational IGLU-S Study

Abstract: The IGLU-S study assessed the effectiveness of insulin glulisine after switching from human insulin/other rapid-acting insulin analogues in patients with type 1 diabetes (T1DM) and type 2 diabetes (T2DM) in a real-world setting in Germany Open-label, prospective, multicentre, non-interventional study in Germany The primary outcome was proportion of patients reaching pre-defined glycosylated haemoglobin A1c (HbA1c) goal at 3, 6, 9 and 12 months Secondary outcomes included absolute changes in HbA1c, rate of hypoglycaemia and 7-point blood glucose profiles Overall, 432 (55 T1DM, 377 T2DM) patients were enrolled Baseline HbA1c was 82% (T1DM) and 83% (T2DM); individual HbA1c targets were 68% and 69%, respectively After insulin glulisine introduction, the proportion of patients achieving their individual HbA1c increased to 436% (T1DM) and 396% (T2DM) of patients at 12 months At 12 months, mean HbA1c was reduced by 086 ± 103% (p < 00001) in T1DM and 101 ± 102 (p < 00001) in T2DM The 7-point blood glucose profile showed a significant reduction in patients with T2DM (p< 00001) and a non-significant reduction in T1DM patients Confirmed symptomatic hypoglycaemia was 57% (T1DM) and 16% (T2DM) There were no cases of severe hypoglycaemia Switching prandial insulin to insulin glulisine resulted in improved effectiveness with 436% of T1DM and 396% of T2DM patients reaching their individual pre-defined HbA1c target within 1 year Switching was safe and was associated with a low rate of hypoglycaemia and adverse events https://awbdbbfarmde ; Identifier: 6818; Date of registration: 23062016

Should Patient with Autoimmune Inflammatory Rheumatic Diseases (AIIRD) be vaccinated with COVID-19 Vaccines?

Abstract: Vaccination is a very important measure for the prevention of various infections worldwide including the recent COVID-19 disease. However, until now the COVID-19 vaccine with various platforms has not been clinically tested on autoimmune inflammatory rheumatic disease (AIIRD) patients, due to caution against possible side effects and unknown efficacy. Several recent studies proved that there is increased risk of SARS-CoV-2 infection in AIIRD patients and moreover, those patients also have worse COVID-19 outcomes. Thus, patients with AIIRD should be prioritized for vaccination because they have an increased burden of infections, including COVID-19. Many studies showed that inactivated/non-live vaccine is safe for AIIRD patients and do not cause disease exacerbations. We conclude that benefits of vaccination greatly outweigh the risks of infection and therefore, COVID-19 vaccines can also be administered safely in stable AIIRD patients.

Fetal exposure to valproate was associated with lower IQ scores at 3 years of age than exposure to other antiepileptic drugs.

Abstract: ED FROM Meador KJ, Baker GA, Browning N, et al. Cognitive function at 3 years of age after fetal exposure to antiepileptic drugs. N Engl J Med 2009;360:1597–605. Correspondence to: Dr K J Meador, Emory University, Atlanta, GA, USA; kimford.meador@emory.edu Sources of funding: National Institute of Neurological Disorders and Stroke and United Kingdom Epilepsy Research Foundation. c Clinical impact ratings: GP/ FP/Primary care 6/7; GP/FP/Obstetrics 6/7; Paediatrics 6/7; Obstetrics 6/7; Psychiatry 6/7 Comparison of antiepileptic drugs used during pregnancy for IQ scores in children at 3 years of age* Outcome Valproate Carbamazepine Lamotrigine Phenytoin Mean difference (CI) Mean IQ (95% CI) 92 (88 to 97) 98 (95 to 102) — — 6 (0.6 to 12.0) 92 (88 to 97) — 101 (98 to 104) — 9 (3.1 to 14.6) 92 (88 to 97) — — 99 (94 to 104) 7 (0.2 to 14.0) *Data were imputed for 77 of 309 children, and analyses were adjusted for significant covariates: maternal IQ, age, and preconception use of folate; antiepileptic drug dose; and infant’s gestational age at birth. C O M M EN TA R Y B abies born to mothers with epilepsy have higher risks of congenital anomalies and developmental delay, and use of antiepileptic drugs increases risk of fetal malformations. 2 The NEAD study is following babies born to mothers with epilepsy who were taking 1 of 4 antiepileptic drugs during pregnancy. Strengths of the study include its prospective design, large sample size, and use of IQ score as a main outcome. A previous observational study found that fetal exposure to valproate was associated with increased risk of major congenital abnormality compared with exposure to other antiepileptic drugs, although that study did not evaluate cognitive effects. Meador et al showed that 3-year-old children who were exposed to valproate in utero had significantly lower IQ scores than those exposed to other antiepileptic drugs, and IQ scores were inversely correlated with valproate dose. Children’s IQ scores were significantly associated with maternal IQ scores for all drugs except valproate. The choice of which antiepileptic drugs to take during pregnancy should be based on individual factors, and physicians should discuss the risks and benefits of different antiepileptic drugs with patients. Based on the results of Meador et al, physicians should not consider valproate as a first choice antiepileptic drug in women of childbearing potential. Changing from valproate to other antiepileptic drugs should be done before conception since abrupt withdrawal or dose reduction of valproate will increase risks of harmful effects from loss of seizure control. Women with epilepsy should be told to plan their pregnancy, and discussion of risks associated with antiepileptic drugs should be part of pregnancy