The Impact of Hospital Information Technology Adoption Process on Quality of Care

Business: 2nd Place (The Ohio State University Edward F. Hayes Graduate Research Forum)We look at the impact of two important dimensions of the process of adoption (sequence and intensity) for Electronic Medical Record (EMR) technologies on cost and quality of care at hospitals. Sequence of adoption is captured in terms of two approaches: the depth-first approach which adopts department level integrative technologies first and the breadth-first approach which adopts organization wide integrative technologies before completing department level integration. Intensity of adoption represents the pace of addition of technologies. Results indicate that the depth-first approach performs better at lower intensity of adoption while the breadth-first approach performs better at higher intensity of adoption.A one-year embargo was granted for this item

Autopsy in Foetal Infant Deaths

Child autopsies are not more difficult than adult autopsies, but do require a number of extra techniques to be performed routinely. This chapter aims to cover the basic techniques required for foetal, perinatal, and infant post mortems. Post mortem examinations of children older than 2 years of age do not differ greatly from adult autopsies

Sexual dimorphism: metric measurements based study in human talus bone

 Background: Identification is the act of establishing the identity of an individual. This is a dynamic process and human remains in form of bones can serve as an excellent tool for establishing the sexual identity of the deceased, along with other methods such as DNA, fingerprints, blood group identification etc. Metric analysis of various bones can serve as a viable alternative in cases when morphological analysis is not possible due to damage to the skeletal remains or as an additive analytical tool to establish a positive identity.Methods: Metric analysis of various parameters of randomly selected 100 pairs of human talus bones (50 male and 50 female) as a means of establishing sexual identity from skeletal remains obtained from unidentified and unclaimed dead bodies brought for autopsy.Results: In the present study we found that the values of all the various dimensions measured were higher among the male subjects as compared to that in female samples as was expected. On further analysis, this difference was found to be statistically significant (p<0.001). For the right sided and left sided talus bone, the probable accuracy for various parameters ranged between 83.3% to 100% each, thus indicating strong correlation between sex of the subject and various measurements.Conclusions: The tarsal and their dimensions are highly sexually dimorphic and are useful in determining sex in individuals of this region

Electric injury: a case series

In the modern era, electricity acts as a vital zone for mankind. The most important external sign of electrocution is the electric mark. The internal findings of electrocution are usually unspecific. The electric mark can also be of postmortem origin and is therefore not a reliable proof that the electric shock occurred before death, unless the survival time was long enough for an inflammatory response of the affected tissue. Various cases of electrocution have been reported in literature but as per the best of authors knowledge none of them have been clearly explained for the establishment of complete electric circuit in reported cases; required for fatal electrocution. In the present case series, authors’ report and discuss the three cases of electrocution under different circumstances with deviations in expectations. Because of the diagnostic problems authors also discuss the significance and careful evaluation of incident/death scene in all definitive as well as suspected cases of electrocution and emphasize on various components required for complete electric circuit for flow of current

Frailty and chronic kidney disease: associations and implications

ABSTRACT Introduction: Frailty and its association with chronic kidney disease (CKD) has been established previously. The present study examined this association further by studying the distribution of frailty among groups defined by different stages of the disease. It also identified associated health deficits and explored their association with estimated glomerular filtration rate (eGFR) and urine albumin creatinine ratio (UACR). Methods: A cross-sectional survey was conducted on 90 non-dialysis dependent CKD Stage 1–4 patients, recruited in three stratified groups of 30 participants each based on the stage of disease. Frailty was assessed using Fried’s frailty criteria and associated health deficits were recorded using a pre-determined list. Depression was screened using a 4-point depression scale. Results: 21.1% of the participants were frail and 43.3% were pre-frail. The proportion of frailty in CKD groups A (Stages 1 and 2), B (Stage 3a), and C (Stages 3b and 4) was 10%, 13.3%, and 40%, respectively. The association of health deficits including co-morbidities, physical parameters, mental status, daily activities, etc. with UACR, eGFR, and CKD stages was not statistically significant. Nearly one in two frail participants was depressed compared with 14% among non-frail participants. Conclusion: The skewed distribution of 21% frail subjects identified in our study indicates an association between frailty and advancing kidney disease. Frail individuals had a lower eGFR, higher UACR, were more likely to be depressed, and had higher count of health deficits and poorer performance on Barthel Index of Activities of Daily Living and WHOQOL. Early identification of depression would improve care in these patients

Morphometric Analysis of Coronary Arteries in Haryanvi Population

Introduction: The “Coronary” term meaning crown is derived from the Latin word “Corona”. The heart pumps the blood for the entire tissues in the human body through the aorta. However, the heart itself gets its nutrition through coronary arteries. Materials and Methods: The study group was comprised of 60 human cadaveric hearts retrieved from the dead bodies of age group 18-50 years brought for medico-legal autopsy. Observations and Results: In 60 heart specimen’s length of RCA-I (34.4-128.8mm, 81.5±18.1), RCA-II (6.2-43.4mm, 20.3±9.9) and RCA-III (9.6-69mm, 38.2±18.7), Length of left coronary artery (3.4-19mm,12.6±3.74mm), length of Left circumflex artery (31.9-144.5mm,79.2±26.2mm), length of Left anterior descending artery (33.4-154.4mm, 105.3±27mm). Conclusion: The name and nature of a coronary artery or a branch defines that vessel’s vascularisation pattern or territory, rather than by its origin. Better anatomical knowledge about the branches of coronary artery and its variation is essential for cardiologists and interpretation of coronary angiograms by radiologist. Keywords: Heart, Right Coronary Artery, Left Coronary Artery. &nbsp; &nbsp

Choking due to fruit drink aspiration

A case of a fatal foreign material aspiration is presented in the following paper. During the autopsy, an orange colored mucus plug was noted in the trachea, which was completely oc-cluding the lumen from mid-level downwards causing a lethal respiratory insufficiency. The bio-chemical and chemical analysis was positive for fructose; there was history of intake of a mango fruit drink just before induction for sur-gery. The anatomo-pathological exam of the lungs showed the signs of acute asphyxia (Mi-croscopic examinations revealed atelectasia, em-physema, eosinophilic exudate and empty spaces). This case represents a rare lethal event related to the aspiration of a fruit drink in a child just prior to induction

Case report on sudden death due to ruptured esophageal varices an autopsy based diagnosis

Late presentation of many of the pathological conditions, leads to theirin un diagnosed which culminating in sudden death. Among the various pathological conditions, gastrointestinal bleeding accounts for 10% of all sudden deaths among which esophageal varices is an important cause of bleeding and death. Here, we are presenting an un diagnosed case of esophageal varices that lead to sudden death of an unknown male individual due to acute bleeding which was diagnosed later on autopsy