Enhanced quality of electronic clinical record through open-source tool

Electronic records are significant to control healthcare information and save patient lives to increase the value of service in healthcare.This paper is drawn from an ongoing, large-scale research project of implementing an Electronic Clinical Record (ECR).The overall aim in this study is to introduce a new tool for the ECR deeper understanding of the complexities and challenges emerging from the implementation of the ECR, and in particular, to study how to manage a gradual transition to a digital record.The aim is to enable the physician and patient to get access to the electronic clinical record.It will propose a new open-source tool to improve the clinical systems.The objective of this research is to ensure sufficient in-depth knowledge of the challenges confronting service delivery related to health, especially in the healthcare sector; and a grasp of how the underlying ICT infrastructure and an ECR might be expected to assist in meeting these challenges.Results of our study identified the need for more research in this particular area as no definitive solution to the long-term access to electronic clinical records was revealed.Additionally, the research findings highlighted the fact that a few medical institutions may actually be concerned about long-term access to electronic records

Diabetic Neuropathy And Its Correlation With Vitamin D3

oai:ojs2.biosight.org:article/1The purpose of this study was to determine neurotransmitter and vitamin D3 levels in both men and women. Fifty healthy middle-aged men and women of 41.17 ± 9.6 and 42 ± 9.59 years respectively were selected. They have no known disease. While 50 male and female diabetic patients with an average age of 55.5 ± 14.92 and 47.87 ± 10.81 years were selected respectively. Anthropological data, including age, weight and length, were recorded in both controls and patients. To test the hypothesis of study relationship between vitamin D and neurotransmitters was analyzed in both groups. The statistical significance was taken at the p-level <0.05. The diabetic patients had neuropathy for 3 to 5 years with high HbA1c. Age and gender do not significantly affect neuropathy in diabetes. The average standard deviation of vitamin D3 is significantly lower in those having diabetic neuropathies, 12,448 ± 3,519 ng / ml (SD), which is not 24,958 ± 5,419 ng / ml, and was compared with vitamin D3 neuropathy in patients who did not have diabetes. (p <0.01). This analysis has shown that the neuropathy of diabetes is strongly linked to vitamin D3 after including confusion such as "Duration of diabetes and HbA1c". In patients with diabetes, the effects of vitamin D3 on neuropathy and the need for further studies ensure that there is a delay in preventing the dose of vitamin D3 or in the onset of neuropathy due to diabete

Prevalence of LBP in male factory workers of Nishat Mills limited, Sheikhupura, Pakistan

Low back pain is common problem in factory worker. However there is a lack of evidence related to work related to LBP in factory workers in Pakistan. This study is conducted to identify the prevalence of Low back pain in factory workers and identify the need for awareness in workers about the working postures and safety measures in Nishat mills limited, Sheikhupura. A survey was conducted with sample size of 170 subjects, collected through non probability sampling technique. Nordic questionnaire (part 1) was used with addition of some questions related to research topic. Self-reported questionnaire Performa was filled. Study population included only male workers aged between 20-45 years with career duration of one or more than one year and working duration of 8 hours. Statistical analysis was done by using SPSS 17.00. According to results 75 out of 170 workers reported low back trouble. The intensity of the low back ache varied from mild to severe. 21 (28%) workers reported mild category of pain, 40 (53.3%) had moderate pain and 14 (18.7%) were having severe pain. Majority (77.3%) workers felt pain for 1-7days during last 12 months. The results showed that there is statistically significant (p<0.05) association between Low back pain and type of work. The workers who do job related to Weight lifting were suffering more frequently from backache comparatively to the workers of manufacturing department. No statistically significant (p>0.05) association between Low back pain and working Posture was found. It was concluded from the study that prevalence of LBP was higher in weight lifting workers. And low back pain was also prevalent in those workers who are engaged with static work like in prolong standing; LBP founds to affect their work activity and reduces the work efficiency

Correlation of serum sodium with severity of hepatic encephalopathy in liver cirrhosis patients presenting at Dr. Ruth K.M. Pfau Civil Hospital Karachi.

Introduction: Cirrhotic patients suddenly or insidiously develop hepatic en-cephalopathy. Approximately three-fourth of the patients usually die within 3 years of onset of their first episode of hepatic encephalopathy. Hypo-natremia, a multifactorial phenomenon in cirrhotic patients may lead to cer-ebral edema and astrocytes swelling.Objective: To determine the correlation of serum sodium with severity of hepatic encephalopathy in liver cirrhosis patients presenting at tertiary care hospital, Karachi.Methodology: This prospective cross-sectional study conducted at Depart-ment of Medicine, Civil Hospital, Karachi between October 31, 2019 till April 4,2020. Data collected from 138 patients after taking written consent; pre-sented as was as mean, standard deviation, frequency and percentages. Effect modifiers were controlled through stratification to see the effect of these on the outcome variable taking p-value of ≤0.05 as significant.Results: Among 138 patients 92 (66.7%) were male and 46 (33.3%) were female. Mean age, duration of symptoms, height, weight and serum sodium in our study was 51.14±4.49 years, 12±7.21 hours, 161±6.78 cm, 85.2±8.54 kg and 132.7±6.32 mEq/L. Out of 136 patients, 28 (20.3%), 35 (25.4%), 54 (39.1%) and 21 (15.2%) patients belonged to sodium quartile 1, 2, 3 and 4; while 21 (15.2%), 41 (29.7%), 28 (20.3%) and 48 (34.8%) belonged to hepatic encephalopathy severity grade 1, 2, 3 and 4. Hepatic encephalopathy severi-ty showed correlation with rising sodium levels.Conclusion: Hyponatremia was found with increased frequency in patients with cirrhosis of liver having a correlation with frequency and severity of hepatic encephalopathy.Key words: Encephalopathy, Liver Cirrhosis, Hyponatremia

Diagnostic Accuracy of Increased Total Leucocyte Count (TLC) And Decreased Absolute Neutrophil Count (ANC) For Diagnosis Of Neonatal Sepsis Taking Culture Sensitivity As Gold Standard

Objective: To find diagnostic accuracy of increased total leucocyte count (TLC) and decreased absolute neutrophil count (ANC) for diagnosis of neonatal sepsis taking culture and sensitivity as gold standard.Methodology: Samples was collected from all the neonates with suspicion of sepsis admitted to neonatal due to severe bad health condition in the Children Hospital, Lahore. Parents were informed for consent. Total 3.5 cc sample was drawn by venipuncture.2.0 cc in CBC voil containing trisodium citrate, this sample was sent to CBC lab for automated CBC on sysmex KX-21 analyzer and peripheral smear. 1.5 cc was taken in specialized containers for blood culture and was sent to microbiology lab. Neonatal sepsis on TLC, ANC and blood count were be recorded. Patients of sepsis was managed as per hospital protocol. Data was analyzed using SPSS.Results: Neonates in this study was at mean age of 3.86±1.81 days. There was almost equal number of males and females neonates. Male were 155(51.7%) and female babies 145(48.3%). It was noted that 182(60.7%) babies were on term while 118(39.3%) were preterm neonates in this study. Neonatal sepsis was positive on TLC in 101(33.7%) cases. in 115(38.3%) on ANC.It was noted that sensitivity of the TLC was 71% while specificity was 66% with a diagnostic accuracy of 68%. On the other and, ANC sowed a sensitivity as 65%, specificity as 56% and diagnostic accuracy of 65%.Conclusion: Conclusively, TLC and ANC is not a good marker for the taking a neonate for the consideration of neonatal sepsis

Role of aldose reductase in Ischemic Heart Disease in subjects visiting Punjab Institute of Cardiology, Lahore

Background:  Ischemic heart disease (IHD) is one of the major cardiovascular diseases due to insufficient blood supply to cardiac cells. Aldose reductase (AR) is a multifunctional enzyme that converts glucose into sorbitol in the polyol pathway. The main objective of this study is to determine the role of aldose reductase in ischemic heart disease subjects in our local population and its relationship with lipid profile. Methods: This cross-sectional study sampled 100 subjects from Jelani Block of PIC Lahore after ethical approval, categorized into two groups depending on disease condition, i.e., the IHD (n=50) group and Control Group (n=50), including healthy subjects. They were taken together with disease history, age, smoking, hypertension, and physical activity examined as inclusion criteria. The level of biochemical parameters was evaluated by using a chemistry analyzer. Hormonal (AR) and cardiac marker (CK-MB) assessments were performed on the ELISA system using commercially available ELSA diagnostic kits. Results: The results revealed that levels of aldose reeducate and CK-MB was comparatively more significant in the IHD group than control, but total cholesterol (TC), triglycerides (TG), and high-density lipoproteins (HDL) showed no significant difference between the control and IHD group. Conclusion: A statistically non-significant relationship was observed between aldose reductase and CK-MB and lipid profile in the IHD patients, indicating the role of aldose reductase in IHD subjects because it increases oxidative stress in cardiac cells

The Validity Of 75gms OGTT For Detection Of GDM Keeping 100gms OGTT As Gold Standard

Objective: To determine the validity of 75gms (Oral Glucose Tolerance Test) OGTT for the detection of GDM keeping 100gms OGTT as the gold standard. Methodology: This was a Cross-sectional validation study done at the Mother and Child Health Centre, Pakistan Institute of Medical Sciences, Islamabad. The duration of the study was Six months from the approval of the synopsis. Data was collected from  March 2019 to September 2019. Informed consent for participating in the study was taken from all 205 patients. The patients' bio data along with the hospital registration number was entered pro forma. The patients were assessed initially by History taking and examination. All pregnant women underwent a 75g oral glucose test in the 2nd trimester at 24-28 weeks of gestation. For this, the patients were sent to the MCH laboratory with overnight fasting where FBS was taken and they were given a 75 g glucose drink. Their blood sample was taken at 1-hour and 2-hour interval. Two or more elevated values out of the 3 blood samples were sufficient to diagnose GDM. Laboratory reports were reviewed and data was entered in the performa (attached) by the researcher. All the diagnosed patients were further evaluated for a 100g OGTT dose at the MCH laboratory with overnight fasting. Their FBS was studied and women were given a 100 g glucose drink and blood samples were drawn at an interval of 1, 2 and 3 hours respectively. Out of the 4 blood samples, two or more elevated values were sufficient to diagnose GDM. Lab reports were entered in the Performa. Results: From a total of 205 patients, the sensitivity and specificity of OGTT-75 g for diagnosing GDM were 83.02% and 82.83%. However, positive predictive and negative predictive value for OGTT-75 g was 83.81% and 82% respectively. However, the overall diagnostic accuracy of OGTT-75 g was 82.93%. Conclusion: Results of this study showed that 75 gms OGTT is highly sensitive (83.02%) and specific (82.83%) for the detection/diagnosis of gestational DM. Advanced screening and diagnosis of gestational DM, and its effective treatment not only inhibit adverse perinatal and maternal outcomes but also save the lives of both child and mother from diabetes in future