Patient Medical Record Research Articles

Analisis Kualitatif Dan Kuantitatif Dokumen Rekam Medis Rawat Inap Sectio Caesarea: Literature Review

Based on the 2018 Riskesdas data, it is stated that delivery is by means of action cesarean sectionreached 17.6%. This event is considered to exceed the standards set by WHO. The purpose of this study was to analyze qualitative and quantitative inpatient medical record documents cesarean section with review literature. The results of this study were based on a qualitative analysis of medical record documents on the 4 articles that were conductedreviews, based on qualitative analysis seen from a review of the completeness and consistency of diagnoses,reviews completeness and consistency of diagnostic records, reviews recording during care and treatment,reviews exists informed consent there are still many medical record documents that are not complete and consistent, one of the factors that influence this incompleteness is the level of awareness of health service workers who lack the importance of completing patient medical record documents. Meanwhile, based on quantitative analysis, from the 4 articles inreviewsthere is only 1 article that states its completeness reaches 100%. Reviews identification of incompleteness on the sex item, reviews authentication is found in the nurse's signature and full name, doctor's name and signature, reviewsreporting of incomplete filling in filling out the main and entry diagnoses and not attaching the results of laboratory examinations, where as on reviews records are in illegible writing in the case of doctors' and nurses' writings that are unclear or illegible, corrections in writing strokes that are not signed.
 
 Keywords: qualitative analysis, quantitative analysis, sectio caesarea.

Patient Satisfaction and Quality of Life After Mastectomy at King Abdulaziz Medical City, Jeddah.

Background Overall well-being after surgical intervention is one of the most important aspects of assessing quality of life (QOL), yet it is not well explored in the literature. In this paper, it wasnecessary to involve the patient's perspective of the nature of their QOL. The burden of being diagnosed with breast cancer is an adaptation to a new lifestyle, having to deal with disease stigma, interpersonal relations problems, and being limited to specificclothing. This can be very challenging for patients. This study aims to identify which patient group, based on their treatment regimen, exhibits higher levels of satisfaction and dissatisfaction compared to other groups. Methods A retrospective, cross-sectional study analyzing the QOL amongfemale breast cancer patients who underwent mastectomy, with or without breast reconstruction, in King Abdulaziz Medical City, Jeddah, between 2009 and 2022. Patients' demographics and phone numbers were obtained from each patient's medical record file in our hospital. Phone call-based interviews were conducted to contact patientsto assess their QOL, satisfaction, and regrets after surgery. We excluded patients who do not speak Arabic, are illiterate, have memory disorders, patients who underwentlumpectomy or palliative mastectomy, patients with metastatic stage 4 cancer at the time of diagnosis, patients who are males, and patients who passed away. Results A total of 2,309 patients were screened during the period aforementioned; a total of 346 patients met our inclusion criteria. All of whom are female participants with a current mean age of 52.3 ± 11.5 years. There were 301(86.99%) participants reported being satisfied, while only45 (13.01%)participants reported being unsatisfied with surgery outcomes. Although the majority of participants were satisfied after mastectomy, many of them still struggled with psychological, social, and/or emotional challenges. These challenges can have a significant impact on a patient's overall well-being and QOL and must be addressed to provide patients with the highest quality of care possible. Conclusion The study findings highlight the significant impact of mastectomyon patients' lives. It is important to consider individual patient experiences and circumstances when evaluating treatment outcomes and patient satisfaction. We observed that patient satisfaction may vary depending on several factors, including patients' baseline satisfaction. Those factors may be psychological, such asbody image issues, low self-esteem, the feeling of losing a body part, and fear of recurrence or metastasis. Other factors may be postoperative-related complications, including lymphedema, redundant skin, chronic pain, and operation scar. Additionally, factors may be socially related, such asloss of confidence,social withdrawal,embarrassment, inability to buy prostheses, being limited to specific clothes, and occupational impact.

Evaluation of Time Constraints for Providing Electronic Medical Record Documents at Murni Teguh Hospital, Medan

The impact of errors in storing medical records causes delays for officers in searching for medical record documents so that services at the polyclinic are hampered. It is necessary to control the incidence of incorrect insertion of medical record documents so that the incidence of incorrect insertion of medical record documents can be reduced. Electronic Medical Record (RME) is a form of health information service that is computerized and recorded. Health service facilities that implement RME in an effort to improve the quality and quality of services. This research is a qualitative research, case study design which aims to evaluate the timing of providing electronic medical record documents for outpatients at Murni Teguh Hospital. Determination of research subjects using purposive sampling technique. The research subjects consisted of the Director of Murni Teguh Hospital, the head of the Medical Record Installation as the main informant, the Patient Registration Officer, and 3 medical record staff as triangulation informants. In collecting data, researchers conducted in-depth interviews, direct observation and document studies. Data analysis was carried out using interactive models, data reduction processes, verification and drawing conclusions. In this study, it was found that the time required to provide electronic medical record documents for outpatients at Murni Teguh Hospital was a minimum of 4 minutes, a maximum time of 9 minutes with an average time needed to provide electronic medical record documents was 6.6 minutes. Obstacles encountered are errors during use, as well as HR who still do not understand the use of electronic medical record systems. By providing electronic medical record documents, the work of the patient medical record department becomes more efficient, makes it easier for officers to search for patient medical records and the benefits that patients get are shorter waiting times.

Monitoring the Use of Antibiotics in Children Patients Acute Respiratory Infection Using ATC/DDD Method

The use of antibiotics needs to be monitored because it is known that excessive use of antibiotics can increase resistance in the community and this has become a focus both nationally and globally. This study aims to evaluate the use of antibiotics in patients with acute respiratory infection at Hasanuddin University Hospital using the ATC/ DDD analysis method. The research design used a cross-sectional study design with retrospective data collection. The sample in this study was patient medical record data from January-December 2021, taken from total sampling and met the inclusion and exclusion criteria. Descriptive statistics are used to present and analyze data. Evaluation of the use of antibiotics by quantitative methods ATC/DDD (Anatomical Therapeutic Chemical (ATC)/Defined Daily Dose (DDD), DDD/1000/ patient/day. The results showed that the most widely used antibiotic was ampicillin (280 mg) 32.96 DDD/1000 patients/day and the lowest was cefadroxil (150 mg) 1.45 DDD/1000 patients/day. Antibiotics with the highest DDD / 100-patient days value and exceeding the WHO DDD standard were ampicillin antibiotics from the penicillin group with a DDD / 100 patient-day value of 32.96 DDD /100 patient-days.

Qualitative Study of Factors Causing Double Numbering of Medical Record Documents at Dharma Yadnya Hospital Denpasar

Introduction: Duplication is when two medical record numbers have the same identity or patient. Duplication or double numbering of medical records occurs because the patient's medical record file is not found when the patient comes for treatment, or the patient needs to remember to bring the Medical Index Card (MIC). This study wanted to determine the factors that cause duplication or double numbering of medical record documents. Method: Data collection was carried out by in-depth interviews, observation, and documentation using case study research with qualitative descriptive methods. The Miles and Huberman method is used in data analysis. The sample of this study amounted to 5 people with purposive sampling techniques. Results: The results of the study showed that the implementation of medical record documents in the registration section uses a computerized system, numbering system using the Unit Numbering System (UNS), alignment system using the Straight Numerical Filling (SNF) system, storage system using a Decentralized system, and the leading cause of duplication of medical record numbers at Dharma Yadnya Hospital is that when patients come for treatment often do not bring MIC or other identity cards. Conclusion: From the study results, the implementation of taking medical record documents has not followed the Standard Operational Procedure (SOP) because it has yet to implement tracers. So, tracers are recommended, and officers must be careful in carrying out health services following existing SOP regulations.

Open injuries and obesity as emerging risk factors for vascular injury in knee dislocations: A retrospective study

PurposeKnee dislocations (KDs) are rare in orthopaedic trauma but can have devastating effects. Failing to diagnose a concomitant vascular injury can lead to amputation. Different methods are used for the diagnosis of a vascular injury and the best approach is under debate.This study aims to examine the risk factor(s) of vascular injury in patients with KDs, examine variables that differ between obese patients and non-obese patients with KDs, and analyse the modalities used to identify vascular injuries in the KD population. MethodsThe electronic patient medical record system at a major trauma centre was retrospectively reviewed to identify knee dislocations from 2015 to 2022. These were stratified based on age, gender, BMI, mechanism of injury, vascular injury, non-vascular complications, and laterality. Co-variates were inputted into a univariable regression analysis, followed by a multivariable regression analysis to identify risk factors of vascular injury in patients with knee dislocations. Co-variates were also compared between obese and non-obese patients using two-tailed t-tests for continuous variables and chi-squared test for categorical variables. ResultsForty patients were identified with a KD, with twenty-eight males and twelve females. The average age was 42.9 years, seventeen patients had a BMI of thirty or over, and eleven patients (27.5%) had a vascular injury. Open injuries (OR: 2.21; 95% CI: 1.19–11.30; p = 0.038) and obesity (OR: 2.66; 95% CI: 1.45–18.69; p = 0.027) are risk factors for vascular injury in patients with knee dislocation. Compared to non-obese patients, obese patients had a higher rate of open injury (p = 0.028), vascular injury (p = 0.017), low-energy injuries (p = 0.014), non-vascular complications (p = 0.017), and amputation (p = 0.036). ConclusionOpen injuries and obesity are risk factors for vascular injury in patients with KD. Compared to non-obese patients, obese patients have low-energy injuries and an increased rate of non-vascular complications, meaning that clinicians could err on the side of caution when investigating vascular injury.Level of evidence: IV.

Faktor-Faktor yang Mempengaruhi Kejadian Hipertensi pada Ibu Hamil Di Rumah Sakit Umum Aliyah Kota Kendari Tahun 2022

Hypertension is a manifestation of disturbances in the hemodynamics of the High blood pressure in pregnancy can reduce blood flow to the placenta, which will affect the supply of oxygen and nutrients to the baby. This can slow the growth of the baby and increase the risk during delivery. Pregnancy Hypertension ranks as the ninth disease at Aliyah Kendari Hospital with a prevalence that increases every year, namely 13% in 2019, 15.2% in 2020, 14% in 2021, and 15.5% in 2022 which has an impact on increasing miscarriage in the first trimester and sudden fetal death (stillbirth). This study aims to determine the factors associated with hypertension in pregnant women at the hospital. Aliyah Kendari City. This research was conducted at Aliyah Hospital, Kendari City in 2022. The research was conducted with a cross-sectional design. The population in this study were pregnant women at Aliyah Hospital, Kendari City during January-June 2022. The sampling technique used a random sampling system, namely by randomizing the patient's medical record number. The type of data in this study used secondary data from medical record data January-June 2022 by collecting data using form sheets and checklist sheets. Data analysis technique using chi-square analysis. Based on the bivariate analysis, it showed that there was a significant relationship between age (p value = 0.000, PR = 3.020), obesity (p value = 0.000, PR = 8.718), family history of hypertension (p value = 0.000, PR = 2.918), parity (p value = 0.000, PR = 2.181), working mother status (p value = 0.003, PR = 1.358). The suggestion of this research is that hospitals can further improve education about hypertension in pregnancy.

#343 : Social Aspects Affecting Dysmenorrhea and Adenomyosis Women in Indonesia

Background and Aims: Dysmenorrhea is a common gynecological disorder occurs in women during their reproductive years, especially in women with adenomyosis and it will change daily function which have negative impact on social life. The high prevalence of menstrual disorder requires appropriate prevention and treatment efforts by recognizing the risk factors and found coping strategies and pain acceptance which can improve social aspects affecting dysmenorrhea and adenomyosis women. Method: This study is conducted in three general hospitals in Indonesia using retrospective data with determined inclusion and exclusion criterias. We used patient medical record with dysmenorrhea and adenomyosis. We analyze their risk factors and outcomes of social aspect in affecting dysmenorrhea and adenomyosis women using statistic program with significant p value [Formula: see text] 0.05. Results: In the last three years 250 patients came to the hospital with chief complaints of abdominal pain especially when their periods. Some of them diagnosed with adenomyosis with or without abnormal uterine bleeding and 160 of them have had surgery with histopathological results showing adenomyosis tissue. All patients who met the inclusion criteria were analyzed further using the questionnaires to find out more about social factors that affect psychological condition of patients with adenomyosis. This research is still ongoing. Conclusion: We can conclude that more than 50% patients with dysmenorrhea is caused by adenomyosis, and they have psychological problems because of that with any significant factors which affect those social aspects in dysmenorrhea and adenomyosis women still analyzed.

HSD89 The Operational Effectiveness of Using an M L-Driven Patient Medical Record: A Simulated Comparative Study Using Real-World Data

HSD89 The Operational Effectiveness of Using an M L-Driven Patient Medical Record: A Simulated Comparative Study Using Real-World Data

Handling Imbalanced Data for Acute Coronary Syndrome Classification Based on Ensemble and K-Means SMOTE Method

Acute Coronary Syndrome (ACS) is a disease that has a high mortality rate with a mortality percentage of 40% after 5 years from diagnosis. Despite the high mortality rate, the conventional process of overestimating ACS can be life-threatening. For this reason, several alternatives for prediagnosis have been investigated to reduce the detection of ACS intensively, one of which is by using a machine learning approach. The machine learning-based prediagnosis approach utilizes patient medical record data as input for making detection models. This approach can produce an optimal model when there is quite a lot of data and the labels have a fairly balanced comparison. However, in machine learning-based ACS detection studies, researchers often do not have balanced data between positive and negative labels that have the potential to cause overfitting. That problem occurs because obtaining additional data with specific labels is difficult. To solve the imbalanced problem in ACS detection, we generated synthetic ACS data using the K-Means SMOTE method. The synthesis data is used as training data to build an ensemble-based machine-learning model. In this study, we obtain an increase in the F1 score of more than 10% when compared to machine learning models that do not use the K-Means SMOTE as an oversampling process. In addition to the greater F1 score, the results obtained are relatively more resistant to overfitting because the data variations in the training set are more diverse.

Drepadom - a Homecare Protocol for Vaso-Occlusive Crisis for Sickle Cell Disease Patients

INTRODUCTION Vaso-occlusive crisis (VOC) is first cause of emergency room (ER) admissions and hospitalizations for sickle-cell disease (SCD) patients. Acute chest syndrome (ACS) is a complication that can occur during VOC and prolong hospitalization, and is the main cause of death in SCD patients. The PRESEV score (Bartolucci - eBioMed 2016), established by our team, allows physicians to evaluate the risk of developing ACS and is calculated upon arrival to the ER and has been validated by an international multicenter study in five different countries (PRESEV 2 - ASH 2020). During the Covid-19 pandemic, we set up a temporary system to monitor VOC patients at home using a telephone hotline and homecare services. The success of this system led to the establishment of DREPADOM, a home-care protocol for VOC management for patients with low risk of developing ACS, or who can be discharged early from the hospital, as standard care (DREPADOM - ASH 2021). Since 2021, Drepadom has been successfully running in seven hospitals in the Parisian region. DESCRIPTION OF SETTING Drepadom has two inclusion modes: 1/ Patients arriving at the ER for VOC with a PRESEV score ≤ 6 and not presenting any exclusion criteria; 2/ patients that are discharged early following hospitalization for VOC and/or ACS (after at least 3 days of hospitalization for patients with PRESEV > 6 upon ER arrival). The Drepadom homecare protocol is activated by a coordinator, who coordinates delivery of PO opioids and parenteral treatments, and a home oxygen concentrator, to the patients' home within four hours. Drepadom uses an online platform and mobile app (Link4Life), where the patient's medical record is shared to the homecare nurse who will perform house calls twice a day. During each visit, the nurse enters the patient's vitals into the app, which are monitored by an on-call SCD expert physician. The online platform also hosts a secure messaging service where nurses, doctors and coordinators can communicate in real-time regarding patient status and care, as well as an automatic alert system that is triggered when vitals fall outside of a predetermined range set by SCD experts. Patient safety is further ensured with a daily calls to the patient using a decision-making algorithm supervised by SCD experts, who arbitrate according to the evolution of the situation (stopping/continuing outpatient follow-up vs. rehospitalization). RESULTS Over a 30-month period we had 209 inclusions for 170 patients into DREPADOM. Of these, 105 were inclusions from the ER and 104 were early discharges (ED). SCD genotype distribution was 83.2% SS, 10.5% SC, and 5.8% S-bThalassemia and female to male ratio was 128:81. In both ER and ED groups, median age was 31 [27-40], 74% of patients were under hydroxyurea treatment and median homecare follow-up duration was 3 [2-4] days. No significant differences in population characteristics were found between the ER and ED groups. In the ER group, 96/105 patients (91.4%) were included with PRESEV ≤ 6. 9/105 (8.6%) patients were included with a PRESEV score >6 only in 2021 during the Covid-19 pandemic, when the ER was saturated. In the PRESEV ≤ 6 group, 9/96 (9.4%) patients were rehospitalized: 1 for ACS (PRESEV = 4), 4 for uncontrolled VOC pain, 2 for chest pain, 2 for fever/infection unrelated to VOC. In the PRESEV >6 group, 3/9 (33%) were hospitalized, one for ACS (PRESEV = 8), one for uncontrolled VOC pain and one for issues with veinous access. In the ED group, patients were hospitalized for a median of 4.5 [3-7] days before being discharged. 27 patients (26%) were included in a post-ACS context. 48/104 (46.2%) had a PRESEV ≤6, of which only 2/48 (4.2%) were rehospitalized for uncontrolled VOC pain. Of the 56/104 (53.8%) patients included with a PRESEV > 6, 8/56 (14.3%) were rehospitalized: 1 for ACS, 3 for uncontrolled VOC pain, 1 for chest pain, 1 for fever/infection unrelated to VOC, 1 for issues with veinous access, and 1 for morphine withdrawal symptoms. For both ER and ED groups, a total of 22/209 patients (11%) required rehospitalization (Figure 1), and no deaths or ICU were reported in either group. PERSPECTIVES Our results confirm that Drepadom is a successful and safe tool to reduce hospital stay for SCD patients.

Android-based Patient Medical Record Data Security Application using AES and RSA Method Cryptography

Android-based Patient Medical Record Data Security Application using AES and RSA Method Cryptography

SISTEM INFORMASI REKAM MEDIS PASIEN PADA KLINIK PAKTEK DOKTER BERSAMA BERBASIS WEB

The Joint Doctor's Practice Clinic is a practice that serves the treatment of various diseases. In the data processing process using handwriting, so that there are problems in processing medical record data, namely to get patient information, visit information, diagnostic information and doctor information, it still takes a relatively long time because they have to search for information manually in the medical record book. The purpose of this study is to analyze the current system, in order to overcome the problems faced at the Joint Doctor's Practice Clinic, by designing a Patient Medical Record Information System at the Joint Doctor's Practice Clinic. Research Framework that will be carried out in solving the problems discussed, namely, identifying problems, data collection, data analysis, system design, implementation, system testing to the maintenance phase. The system development method uses a waterfall model, the implementation of this research uses the PHP programming language and MySQL DBMS. To produce a data processing application that is expected to facilitate the processing of medical record data and the manufacture of medical record reports

Antibiotic Prescribing Practice in a Paediatric Outpatient Clinic in Owerri, Imo State, Nigeria

Background: Antibiotics are amongst the most frequently prescribed drugs for children in outpatient clinics but irrational prescribing can cause medication errors, antibiotic resistance and treatment failure. Examples of irrational prescribing includes poly-pharmacy, over use of injections, inappropriate use of antimicrobials and failure to prescribe in accordance with treatment guidelines.
 This study sought to assess antibiotic prescribing practice in the children’s outpatient clinic of the Federal university teaching hospital Owerri, Imo state.
 Materials and Methods: This was a descriptive prospective study carried out in the Children’s Outpatient Clinic (CHOP) of the Federal university teaching hospital Owerri, Imo state Nigeria between April and June 2021. During the study period, medical record of patients who attended the CHOP and who had antibiotic(s) prescribed were collated. Prescribing practice was assessed using the World Health Organization prescribing indicators.
 Results: A total of 495 antibiotic prescriptions were made for 478 patients. This gave 1.04 as the average number of medicines prescribed per patient encounter. 1.6% of the antibiotics were prescribed as injections and 79.2% of the prescriptions were in generic names. While only 96.8% of the prescriptions were from the Nigerian essential drug list, the three most prescribed antibiotics Amoxicillin/Clavulanic acid, Cefuroxime and Amoxicillin are all listed in it.
 Conclusion: The antibiotic prescribing practice in the children’s outpatient clinic was rational with regards to average number of medications per patient encounter and percentage of encounters with injection prescribed. It was irrational in terms of percentage of antibiotics prescribed in generic names and percentage of antibiotics prescribed from the Nigerian essential drug list.

The effect of sugammadex on postoperative urinary retention post-laparoscopic and robotic hysterectomy with and without concomitant procedures.

This study was aimed at determining the effect of sugammadex versus a combination of glycopyrrolate and neostigmine (GN) for neuromuscular reversal blockage on transient postoperative urinary retention (TPOUR) in patients undergoing a laparoscopic and robot-assisted laparoscopic hysterectomy. We conducted a retrospective cohort study in patients undergoing a laparoscopic or robotic hysterectomy between February 2017 and December 2021. Patients with and without concomitant procedures were included. Demographics and perioperative data were extracted from the patient's medical record. Before discharge, all patients were required to spontaneously void and have a post-void residual of less than 150ml. We identified 500 patients and 485 were included in the final analysis. We had 319 subjects who received sugammadex and 166 GN combination. Both groups had overall similar demographics and perioperative characteristics. Most patients had a conventional laparoscopy procedure (391 [82.5%]) compared with robotic (83 [17.5%]). Patients who received GN were significantly more likely to be discharged home with an indwelling catheter (odds ratio [OR], 1.82; 95% confidence interval [CI], 1.09-3.05). After adjusting for perioperative medications and sling implantation during the surgery a logistic regression model continued to demonstrate that patients who received GN had significantly higher odds of being discharged with a catheter (OR, 1.79; 95% CI, 1.03-3.12). Our findings suggest that sugammadex decreases the odds of TPOUR after laparoscopic hysterectomies with and without slings compared with the combination of GN. Additional prospective trials are required to confirm this finding.

Survey of Pulmonary Embolism Risk Stratification Methods in the Emergency Department and Barriers to Electronic Health Record Documentation

Introduction Pulmonary Embolism (PE) is a major cause of morbidity and mortality worldwide. Diagnosis is essential as untreated PE has a 30% mortality rate. Currently, computer tomography pulmonary angiogram (CTPA) is the standard of care to diagnose PE. However, this modality is expensive, exposes patients to radiation and increases risk of contrast induced nephropathy. Furthermore, only 5% of CTPAs performed are positive for PE signifying that many unnecessary tests are being performed. To address this gap, Pre-Test Probability (PTP) tools have been developed to safely exclude patients with low risk of PE and limit iatrogenic harm from over testing. Despite the tools being developed over 20 years ago, they are not widely available in electronic health record (EHR) systems and even when they are built in, uptake remains low. Methods Three large integrated health systems using Epic EHR systems across five states (MA, WI. MN, AZ, FL) built electronic PTP assessments into their EHR systems to safely exclude patients with low risk of PE and limit over testing. Two sites made the PTP optional, and one site made it a forced function (providers were forced to complete PTP prior to ordering CTPA unless a D-dimer result was present in the prior 48 hours). To assess the usability of these EHR tools, the team conducted a survey with ED clinicians across the three test sites. The survey was created to identify which PE risk stratification methods were employed by ED clinicians (EHR embedded PTP tool, apps on their phone, web applications like MDcalc, calculations from memory, or if they relied on clinical gestalt), and to identify barriers to using the EHR embedded PTP. Results Site 1 had 47 respondents, Site 2 had 94 respondents, and Site 3 had 16 respondents. Two key findings emerged from the survey (Figure 1). First, clinicians used a variety of risk stratification approaches and few of them documented their risk assessments in structured fields in the medical record. Second, clinical gestalt was the most used PE risk stratification approach, and this was true across all three test sites. In addition, the health system with a PTP prompt before clinicians could proceed with CTPA orders (Site 3) did not have a higher percentage of clinicians who reported using the EHR embedded tool than sites that did not prompt clinicians to fill in the PTP. Clinicians cited a variety of different barriers to using the EHR embedded PTP tool (Table 1). Conclusion While many clinicians indicated intermittent use of PTP criteria to aid in the diagnosis of PE, risk factors and scores from phone apps, web tools, and calculations from memory are unlikely to be documented in the patient's medical record, which means that they are not accessible to all members of the ED care team and cannot be used for electronic clinical quality measure. The biggest hurdles to increasing the use of structured PTP assessments in the ED setting to safely exclude PE and limit iatrogenic harm from over testing are (1) obtaining buy-in from ED clinicians that the PTP tools provide value over clinical gestalt, at least for a subset of patients who could most benefit, and (2) identifying best practices for incorporating PTP tools into EHR systems that make the tools easier to access and use 3) developing and implementing effective education and awareness programs around the PTP tools. This survey adds to the body of literature on PTP assessments in the ED setting and can help inform further research that is needed to continue to improve the diagnosis of PE. Funding: This project is funded in part by the Gordon and Betty Moore Foundation through Grant GBMF10778 to the American Society of Hematology.

Comparison of Maternal and Neonatal Outcomes Among COVID-19 and Healthy Pregnant Women in the West of Iran: A Retrospective Cohort Study

Background: In the COVID-19 epidemic, pregnant women, fetuses, and newborns are a high-risk population that is more susceptible than the general population. These groups are more susceptible to serious respiratory illnesses and pneumonia because of their weakened immune systems. This study compared maternal and neonatal outcomes in postpartum women with COVID-19 with similar healthy women at the hospital Study Design and Methods: In this retrospective cohort study, the characteristics of 100 pregnant women with COVID-19 (confirmed by a positive PCR test during pregnancy) were compared to 150 healthy pregnant women who were referred to Fatemieh Hospital in Hamadan from March, 2020 to February, 2021. The maternal and neonatal outcomes were collected from the medical record of patients and analyzed using SPSS software (Ver. 26). Results: No significant differences were observed in the average ages (± standard deviation) of the two groups of COVID-19 (30.25 ± 6.24 years) and healthy (29.48 ± 6.73 years) women. In this study, pregnant women were infected with COVID-19 from weeks 7 to 41 of gestation, with a median infection time of 35 weeks. The odds ratio (95% confidence interval) of pre-eclampsia and preterm birth was significantly higher in women with COVID-19 than in healthy women with the following values 2.79 (1.61, 7.34) and 22.26 (2.86, 173.33), respectively. Conclusion: Pregnant women suffering from COVID-19 had considerably greater rates of gestational issues, neonatal difficulties, pre-eclampsia, and premature delivery, according to the findings of this study. During epidemics, it is advised that pregnant women and their newborns receive more basic care.

Deteksi Kandiduria Pada Wanita Penderita Diabetes Melitus Di Puskesmas I Denpasar Barat

Diabetes mellitus is a disease associated with metabolic disorders in the body with the characteristics of an increase in the body's blood sugar levels. In people with diabetes mellitus, candiduria infection can occur due to excessive growth of Candida fungi in the urinary tract. Patients are declared candiduria if Candida is found in the urine >103 CFU/mL. The study ao aimed to determine whether candiduria occurred in women with diabetes mellitus who were examined at the West Denpasar Health Center I. The sampling technique used purposive sampling. The sample used was 53 urine using the patient's medical record data for December 2022. Sample analysis was carried out at the Parasitology and Mycology Laboratory STIKES Wira Medika Bali. Candiduria was detected by examining the number of colonies per ml of urine on Sabouraud Dextrose Agar. Identification of causative species was carried out by Gram microscopy and germ tube test. Based on the examination results, 2 samples (3.8%) were positive for candiduria and 51 samples (96.3%) were negative. Identification of Candida species known to cause candiduria in both samples was caused by C. albicans. With the characteristics of an oval, gram-positive blastospore, and a germ tube test, the formation of blastospores is like germinating cells. Based on the results of the study, it is expected that respondents maintain body immunity, blood sugar levels, and cleanliness of the genital area so as to reduce the risk of candiduria.

Massage manipulation and progression of osteosarcoma, does it really correlate: a combination of prospective and retrospective cohort study

In Indonesia, the challenge of osteosarcoma progression is further worsened by patients' dependence on traditional massage therapy, low socio-economy, and educational status. This study aims to analyze the differences in the characteristics, laboratory findings, surgery techniques, degree of histopathological necrosis, and metastasis between osteosarcoma patients with and without prior massage manipulation therapy. This research is an analytical observational study with a prospective and retrospective cohort design. Patients were treated and followed for one year to evaluate the occurrence of metastasis. Prospective data was collected through interviews, and secondary data was collected from the patient's medical record. Of 84 subjects analyzed, 69% had a history of massage. There was an increase in LDH and ALP in patients with massage manipulation (p = 0.026). The median time to metastasis from baseline in the massage group (4 months) was statistically significant compared to the non-manipulation group (12 months) (p < 0.0001). This research found that massage therapy significantly increases LDH and ALP levels, making amputations more likely to be performed and a higher risk of metastasis that lowered the survival rate. The onset of metastasis was three times faster in patients with prior massage therapy. Therefore, we strongly recommend against massage manipulation therapy in osteosarcoma patients.

Telemedicine Use Following Onset of the COVID-19 Pandemic Was Associated With Youth and White Race but Not With Socioeconomic Deprivation: A Retrospective Cohort Study of Orthopedic Patients.

The use of telemedicine increased greatly following the onset of the COVID-19 pandemic. It is unclear whether and how sociodemographic factors have affected orthopedics patients' use of this technology in the pandemic. The aim of this study was to determine how patient demographic variability in telemedicine use is influenced by the Area Deprivation Index (ADI) and distance to clinical site among patients seeking care for hip and knee arthritis from orthopedic surgeons. Demographic data and visit type were collected from the electronic medical record for patients seen in our academic medical center either before or during the COVID-19 pandemic by orthopedic surgeons who specialize in hip and knee arthroplasty. Univariate and multivariate analyses were performed regarding age, race, insurance status, ADI, and distance to a clinical site. In the COVID era, among 4901 visits with 3124 unique patients, those using telemedicine were younger and more likely to be White compared to those who did not use telemedicine. There was no significant difference in telemedicine use based on ADI, distance to a clinical site, or insurance status. This retrospective analysis suggests that orthopedic patients who were White and of younger age were more likely to use telemedicine in the first year of the COVID-19 pandemic. There was no statistically significant relationship between distance from a clinical site or ADI and telemedicine use, suggesting that factors other than these are greater contributors to telemedicine utilization in our cohort. Further information is needed to determine how telemedicine may disproportionately limit access to orthopedic care according to these and other patient factors.