Record Files Of Patients Research Articles

Enhancing Medical Record Quality via Coding Accuracy

Elements of coding quality in medical records include reliability, completeness, validity, and timeliness. This analytical study, employing a quantitative approach, evaluated medical record files of patients with injuries and external cause cases at Ibnu Sina Hospital, Gresik, from October to December 2022. Using the Slovin formula, 161 samples were randomly selected from a population of 271 records. The study variables were reliability (diagnosis readability), completeness (diagnostic code completeness), and validity (5th digit use, diagnosis code accuracy, and external cause code accuracy). Data were analyzed using SPSS and the Chi-Square test. The study found significant relationships between the validity of diagnosis codes and the quality of medical records (p = 0.0001). Reliability showed no significant impact (p = 0.470), while completeness (p = 0.0001) and the use of the 5th digit (p = 0.0001) were significantly related to diagnosis code accuracy. These findings highlight the critical role of accurate coding in improving medical record quality and suggest targeted improvements in coding practices. Highlight: Significant Link: Diagnosis code accuracy is crucial for medical record quality. Critical Factors: Completeness and 5th digit use are key for accurate coding. Targeted Improvements: Focused coding practice enhancements can boost record quality. Keyword: coding quality, reliability, completeness, validity, medical records

Lidocaine patch as noninvasive alternative treatment option in children with anterior cutaneous nerve entrapment syndrome: A retrospective case series.

Chronic abdominal pain in children is occasionally caused by anterior cutaneous nerve entrapment syndrome (ACNES). Diagnosing and treating this typical peripheral abdominal wall neuropathy is challenging. Management usually starts with minimally invasive tender point injections. Nevertheless, these injections can be burdensome and might even be refused by children or their parents. However, a surgical neurectomy is far more invasive. Treatment with a Lidocaine 5% medicated patch is successfully used in a variety of peripheral neuropathies. This single center retrospective case series aimed to evaluate the effectiveness and tolerability of lidocaine patches in children with ACNES. Children aged under 18 diagnosed with ACNES who were treated with a 10 day lidocaine patch treatment between December 2021 and December 2022 were studied. Patient record files were used to collect treatment outcomes including pain reduction based on NRS and complications. Twelve of sixteen children (mean age 13 years; F:M ratio 3:1) diagnosed with ACNES started the lidocaine patch treatment. Two patients achieved a pain free status and remained pain free during a 4 and 7 months follow-up. A third child reported a lasting pain reduction, but discontinued treatment due to a temporary local skin rash. Five additional patients reported pain reduction only during application of the patch. The remaining four children experienced no pain relief. No adverse effects were reported. Lidocaine patches provides pain relief in a substantial portion of children with ACNES.

Study of vesicular mole and its outcomes

Vesicular mole is defined as the premalignant form of gestational trophoblasticneoplasia. I5-20% of complete moles and <5% of partial moles will develop into Gestational Trophoblastic Neoplasia. It is of clinical and epidemiological interest because of its potential for significant consequences on women's health. The study aims to determine the incidence, outcomes and complications of pregnancy with vesicular mole at SKNMC hospital, Pune. It was a retrospective study. Approval for the study was obtained from institutional ethical committee. Data was collected from OPD, OT register and Indoor patient record file from August 2015 to August 2020. Proformas were filled. All the collected data was compiled in a master chart, analysed and outcomes of different variables under study have been expressed in the form of mean, frequencies, percentages and charts. The incidence of molar pregnancy was 0.17% or 1 in 561 deliveries. Vesicular mole occurred more in the age group 16 to 25 years, was lowest in age group 31-35yrs. Vesicular mole was most common in nulliparous women. The mean gestational age of the patients at presentation was 9.4 week. Hemorrhage after suction and evacuation was seen in 26% cases needing intra and post-operative blood transfusion. 6% of patients developed thyrotoxicosis. During follow up invasive mole was diagnosed in 2 cases (6%). The case fatality rate is 2.9% in our study. 1 patient (3%) developed choriocarcinoma and died within 6months after hysterectomy and chemotherapy. The incidence of 1 in 561 deliveries which is higher than non-Asian countries 1/752 but lower than other Asian countries 1/387. The routine first trimester ultrasonography helps in early detection of asymptomatic women. If not followed up regularly it can be life threatening.

Presentation, treatment profiles, and outcome of snake bite patients presented in emergency department at a tertiary hospital in Eastern Nepal.

Snake bite is one of the most common animal bites in Nepal. Different species of snake cause different clinical presentations. The incidence of snakebite is very high in rural Nepal. The objectives were to assess the presenting pattern, demographic profile, outcome, and treatment profiles of snakebite victims admitted to the emergency ward. A retrospective cross-sectional study was conducted among the patients who presented in emergency department with alleged history of snake bites from 2015 to 2016. The patient's record files were reviewed and the relevant data were recorded on a self-designed proforma. Descriptive statistics were calculated using SPSS version 11.5. Out of 137 snakebite victims, 73 (53.3%) were female. The mean age was 35.17 ± 18.27 years. The upper limb (59%) was the most common site for snake bites followed by the lower limb (35.1%). Fifty patients (36.2%) were bitten by snakes during night (20.00-2.59 AM). Twenty-eight (20.4%) patients presented with ptosis as the most common sign and symptom followed by diplopia (15.3%). Out of 137 patients, 39 (28.5%) were admitted, 65 (47.4%) discharged, and 12 (8.8%) patients expired. Antisnake venom was given to 30 patients among which 23 patients (76.7%) were improved. Snake bite is one of the major problems in rural Nepal. It can be easily managed if treatment is given properly and in a timely manner. The importance of effective first aid management and effective treatment have to be disseminated among the peoples in rural areas via social media and radio.

Risk Factors Associated with Mortality in Patients with Mucormycosis Post Severe Acute Respiratory Syndrome Coronavirus-2 (Sars-Cov-2) Infection.

To study the potential risk factors associated with mortality in patients with mucormycosis. A retrospective study of 490 patients with diagnosis of sinonasal mucormycosis was done. They were divided in two groups-Group A included 87 patients that expired during the study period and Group B included 403 control patients. All the demographic, clinical and outcome parameters were collected from the patient's record files and noted in a structured case proforma and were analysed. During the mean hospital stay of 22 ± 6days, 17.7% patients expired during the treatment course. Multiple risk factors like uncontrolled diabetes, dyselectrolytemia, underlying renal disease and extensive nature of the disease involving orbit, intracranium and with pulmonary dissemination, all were associated with high mortality in Mucormycosis. Early recognition and appropriate management of the secondary factors can grossly reduce the risk of mortality in patients with mucormycosis.

Impact of Thyroid Cancers on Thyroid Hormones among Patients Attended Tripoli University Hospital

Thyroid cancer is one of the most common endocrine system malignancy, accounting for 3.8% of new cancer cases in the US and ranking ninth overall. The number of people diagnosed with thyroid cancer has increased dramatically over the last three decades, indicating the disease's global severity. The purpose of this study was to determine the effect different types of thyroid cancers on thyroid hormones (TSH, T4 and T3). This study was conducted in the Oncology and Endocrinology departments of Tripoli University Hospital (TUH). A total of 70 thyroid cancer patients were targeted, and data was collected using patient record file. TSH, T4 and T3 levels monitored and analyzed in biochemistry laboratory using Cobas e411 Fully Automated Machin. Thyroid cancer struck most females than males. Thyroid cancer incidence has increased among people aged 20 to 40. Most thyroid cancer cases are papillary thyroid carcinoma. Thyroidectomy was done with an 87.14% success rate. The level of TSH hormones increased in thyroid cancer patients. Also, the percentage of T4 hormone levels was mostly increased, whereas thyroid cancer had no proven effect on T3. Papillary thyroid carcinoma was the most common thyroid cancer. There was pronounced effect of thyroid cancer on the TSH and T4 hormone, however T3 hormone remained unchanged.

An Audit of Mortality Pattern in the Neonatology Unit of the University of Uyo Teaching Hospital, Uyo, Nigeria: A Seven-Year Review.

Most neonatal deaths occur in low and middle-income countries (LMICs). These deaths can be prevented through universal access to basic high-quality in-patient health services. Prematurity, neonatal sepsis, and perinatal asphyxia have been reported as the leading causes of in-patient neonatal deaths. This study aimed to assess the trend of neonatal mortality in our hospital, determine the pattern and causes of neonatal mortality, and evaluate the factors associated with neonatal mortality in our facility. This was a retrospective cross-sectional descriptive study conducted in the Special Care Babies Unit (SCBU) and Sick Babies Unit (SBU) of the University of Uyo Teaching Hospital, over seven years (2015-2021). Demographic, clinical, and mortality data was extracted from the case record files of patients into a structured proforma and analysed. There was a total of 228 deaths comprising 130 males (57.02%) and 98 (42.98%) females. The median age at demise was 4.00 (IQR = 1.00 - 12.00) days for both genders. The majority (71.50%) of deaths occurred in the Sick Babies Unit. More males died than females (57% vs 43%). The three leading causes of death were: prematurity (38.60%), neonatal sepsis (38.16%), and birth asphyxia (13.60%). The leading causes of neonatal mortality in our environment are prematurity and neonatal sepsis. There is a need for increased community education on antenatal care, training of traditional birth attendants, improved newborn transportation facilities, and provision of neonatal intensive care facilities.

Reliability of Dhaval–Rohan angle for assessment of vertical dysplasia

Objectives Assessment of Dhaval–Rohan (DR) angle as a vertical dysplasia indicator. Materials and methods One hundred and forty lateral cephalometric radiographs of Egyptian orthodontic patients of both sexes with age ranging from 16 to 28 years old, collected from the record files of patients admitted for treatment of various malocclusions. The enrolled cases were subdivided based on SN/MP angle, FH/MP angle, Y-axis/FH angle, gonial angle, and LAFH/TAFH, into high angle (hyperdivergent), low angle (hypodivergent), and average (normodivergent) cases according to Aboul-Azm and colleagues. Each case had to have a minimum of three of the five parameters indicating its pattern of growth, DR angle was constructed by using three skeletal points; C (center of condyle where the angle located), M (center of premaxilla), and G (center of symphysis of mandible), the measured data were led to the computer and statistically analyzed using the Statistical Package for Social Sciences software, version 24. Quantitative data were expressed using range (minimum and maximum), mean, and SD. Significance of the obtained results was judged at P value less than 0.05. Results There is a strong correlation between the conventional parameters and DR angle. The cutoff point of the DR angle below 28° indicates a horizontal growth pattern, between 28.5 and 32.5° indicates an average growth pattern, and above 32.5° indicates a vertical skeletal growth pattern. Conclusion The DR angle is a reliable parameter in assessing vertical skeletal growth pattern with minimal cephalometric landmarks that easily and accurately located.

Aplikasi Rekam Medis Pada Puskesmas Bulukandang Berbasis Android Dengan Metode Waterfall

Medical records are patient record files containing patient examinations and examination histories from the initial patient treatment until they are needed again. At the Bulukandang Health Center, there are obstacles in the patient's medical record service, because recording is still carried out using a hybrid system. The hybrid filing system used by the Bulukandang Health Center is in the form of physical documents and archiving of paper documents. The purpose of this research is to create a Medical Record application at the Bulukandang Health Center based on Android. Before this application is built, this application is first designed using Figma. Then this medical record application was built using Android Studio software, accessing the data with get and post methods through the RESTFUL API. The Waterfall method is used in system development. Based on the results of Black Box testing the application built can be used without errors and bugs. Based on testing using the usability scale obtained a score of 81 from 10 respondents' responses, indicating that a score of 81 for the Acceptability Ranges version was obtained Acceptable. So that this application can help staff and employees of the health center, so that work is more effective and efficient.

IMPACT OF CLINICAL PATHWAY IMPLEMENTATION OF LAPAROSCOPIC APPENDECTOMY ON LENGTH OF STAY, HOSPITAL COST AND PATIENT HEALTH OUTCOME AT EMC PEKAYON HOSPITAL

The most important goal in health services is to produce patient health outcomes that benefit patients and continue to prioritize the quality of health services. The results of the interviews conducted found that referrals from insurance agents also decreased due to problems related to the variety of services that have an impact on increasing service costs. The purpose of this study was to determine the impact of implementing a clinical pathway as a tool for quality and cost control on length of stay, hospital costs, patient health outcomes in groups that implement and do not implement clinical pathways. This study took place at the EMC Pekayon Hospital with a population of all medical record files of patients who had a diagnosis of appendicitis with laparoscopic appendectomy surgery in the period 2021 to November 2022 who met the inclusion criteria, namely 69 patients. Clinical pathway is the independent variable and length of stay, hospital cost, patient health outcome is the dependent variable. The research design used is analysis with qualitative in-depth interviews and documentation studies. The results showed that the implementation of the clinical pathway had an impact on the length of stay, hospital costs and patient health outcomes. The implications of this research in theory will prove the impact of the implementation of research variables and managerially will further improve the service evaluation system in hospitals to improve service quality and cost efficiency.

Uterine Malignancy: Pathological Pattern and Changing Incidence in a Teaching Hospital in Jeddah, Saudi Arabia.

Uterine carcinoma is one of the most common malignancies affecting women globally. It is the second most common gynecologic malignancy in impoverished countries and the most common in industrialized countries. To describe the histopathological patterns of uterine malignancies and their changing incidenceat King Abdulaziz University Hospitalfrom 2011 to 2020. A retrospective study was conducted to analyze female patient record files from 2011 to 2020who underwent uterine resection surgery at the King Abdulaziz University Hospital, Jeddah, Saudi Arabia. A total of 263 patients were included. The age ranged from 30 to 95 years old; median age of 61 years. The majority (71%) presented with the complaint of abnormal uterine bleeding. Themostcommon histopathological diagnosis was endometrioid carcinoma (70%), followed by serous carcinoma (13.7%). The lowest reported uterine cancer diagnoses were in the year of 2011 with (<5%)of the caseswhile the highest were in the year of 2020. These findings demonstrate avariable incidence of endometrial carcinomas in the study population over the study period.With trends of an increasing incidence till 2018 followed by a marginal reduction in 2019 and 2020. The most frequent histopathological diagnosis of uterine cancer was endometrioid carcinoma followed by serous carcinoma, (70%)and (13.7%) respectively. Type 1 endometrial carcinoma was prevalent throughout the decade surpassing the type-2 endometrial carcinoma. The trend also shows a steady increase in the frequency of uterine cancer which is alarming and prompts further research to determine factors associated with and molecular classification of reported uterine cancer cases.

Spectrum of Fungal Infections in a Tertiary Care Centre of North India: Pre-COVID and COVID Scenario and Implications.

Background Rhino orbital mucormycosis is a rare and very aggressive entity. A sudden rise of this entity has been noticed with the insurgence of the COVID-19 pandemic both among immunocompromised and immuno-competent patients. This study was done to determine any possible correlation between these two deadly diseases. Materials and Methods This was a retrospective observational study done in the pathology department of a tertiary care center in North India over a three-year period (January 2019 - December 2021). Patient details along with relevant clinical data were retrieved from the patient's record file. Hematoxylin and eosin-stained slides of diagnosed cases were taken from the department records. Results A total of 45 patients (34 males, 11 females) were included in the study, seven of which were ophthalmic exenteration specimens. The mean age of the patients was 52.68 years. Fifteen cases showed COVID-19 reverse transcription-polymerase chain reaction (RT-PCR) positivity. Histopathology revealed the presence of mucormycosis in all the cases. There were six cases showing granuloma formation and 14 cases revealed mixed fungal infection. Optic nerve involvement was seen in six cases of exenteration specimens. Conclusions The present study showed a sudden resurgence of secondary fungal infections, especially during the second wave of the COVID-19 pandemic. Associated co-morbid conditions and injudicious use of steroids and antibiotics have been the cause of depressed immunity leading to the infections. One must be aware of such co-infections to facilitate timely medical management to reduce morbidity and mortality.

Outcome of Covid-19 Patients Admitted in Emergency Department of Karnali Academy of Health Sciences, Teaching Hospital

Introduction COVID-19, a global health problem, was first identified in the Hubei province, China. While various clinical features of the diseases have been documented, the complete clinical profile is yet to be understood. The purpose of this study is to evaluate the outcome of Covid-19 after admission in the emergency of KAHS during the year 2021January – 2022 January. Methods This is a hospital-based, retrospective, observational study done in the emergency department of Karnali Academy of Health Sciences (KAHS), Jumla. The data was taken from the registry, including the record files of patients with Covid-19 admitted in the hospital from 2020 January to 2021 January. The retrieved data was initially entered in an Excel sheet followed by its analysis. We carried out Kaplan Meier survival distribution analysis to determine the survival probability and predictors of Covid-19. Results Of the 516 Covid-19 positive patients who were admitted in the hospital, 53.5% were males. For the total patients, the mean duration of hospital stay was 8.02±5.32 days with the proportion of patients who died during treatment being 3.7% (n=19). As described by the Kaplan-Meier curve and the accompanying survival table, the mean survival time of the overall patients was 36.74 days (95% CI=35.6–37.8). Moreover, the cumulative survival rate was seen prominently decreased for older patients and those admitted in the intensive care unit and/or ventilator. Conclusion The increased mortality rates seen in the older patients and those admitted in critical care setting clearly calls for the importance of proper and timely intervention.

Treatment and Outcome of Anterior Inferior Cerebellar Artery (AICA) Aneurysms: Helsinki Series of 15 Consecutive Patients.

Objective Anterior inferior cerebellar artery (AICA) aneurysms are rare posterior circulation lesions that are challenging to treat. This article presents the treatment and clinical outcome of AICA aneurysms in an unselected cohort of patients. Methods A retrospective analysis of patient record files, digital subtraction angiography, and computed tomography angiography images of 15 consecutive patients harboring AICA aneurysms treated between 1968 and 2017. Results Of the 15 AICA aneurysm patients reviewed, 12 (80%) were females. Twenty percent had intracerebral hemorrhage and 40% presented with intraventricular hemorrhage. Eleven out of 15 (73%) patients presented with subarachnoid hemorrhage (SAH); 82% of SAH patients had a good-grade SAH (Hunt and Hess grade 1-3). Eleven patients (73%) were treated surgically, three (20%) were treated conservatively, and one (7%) had coil embolization. In 27% of patients, a subtemporal approach with anterior petrosectomy was performed. A retrosigmoid approach was used in the remaining 73%. In 18% of the patients, a parent vessel occlusion was necessary to occlude the aneurysm. Five out of 11 (47%) of the patients developed postoperative cranial nerve deficits. Twenty-seven percent developed shunt-dependent hydrocephalus. All patients who presented with an unruptured AICA aneurysm had good clinical outcome (modified Rankin scale [mRS] 1-2). In patients with SAH, 82% achieved good clinical outcome and 18% had poor clinical outcome (mRS 3-6) after 1 year. Conclusion Surgical treatment of AICA aneurysms has a high rate of cranial nerve deficits but most of patients have a good long-term clinical outcome.

Effective mandibular and maxillary base length in developing Class III malocclusions with high and low mandibular plane angles

Introduction Skeletal Class III is one of a complex sagittal interjaw relationship. It is the result of malrelation in sagittal position of one or both jaw bones or disproportionate ratio of their length. Objective This study was carried out to assess the effective mandibular and maxillary bases length in developing Class III malocclusion with high and low mandibular plane angles. Materials and methods Cross-sectional study was carried out on a selected sample of 75 lateral cephalometric radiographs of orthodontic patients of both sexes with age ranged from 6 to 12 years old. They were divided into three equal groups. Group 1: normal ANB and mandibular plane angles as a control group, group 2: skeletal Class III with low mandibular plane angles, and group 3: skeletal Class III with high mandibular plane angles. The sample was collected from patient record files at the clinic of the Orthodontic Department, Faculty of Dentistry, Tanta University, Egypt. Results A statistically significant difference was found in the effective maxillary length between group 1 and group 2 and 3. While effective mandibular length showed no statistically significant differences between the three groups. Conclusion Short maxillary base length is the main etiological factor for skeletal Class III malocclusion. While prominent mandibular base length has minimal effect in development of skeletal Class III malocclusion.

The clinical success of repaired posterior composite restorations with and without silane application.

To evaluate the clinical success of posterior composite restorations repaired with and without silane application for up to 2 years. In this retrospective study, patient record files acquired from the 40 patients who were treated due to needing repair for two class II defective composite restorations and visited the clinical practice for regular check-up visits were used. In the experimental group, the defective restorations were repaired using a silane coupling agent (Porcelain Primer), a universal adhesive (G-Premio Bond), and a microhybrid resin composite (Charisma Smart). In the control group, the restorations were repaired using the universal adhesive and the resin composite without silane coupling agent application. The repaired restorations were blindly assessed by two calibrated examiners using modified USPHS criteria at baseline, 6 months, 1, and 2 years. The data were analyzed using non-parametric tests (p = 0.05). After 2 years, 80 repaired class II restorations were evaluated. No restoration of either the control or silane-treated group failed. After 2 years, there were no statistically significant differences between the experimental and control groups (p > 0.05). The differences in surface roughness were observed in each group over time (p < 0.05). There were no variations in other criteria over time (p > 0.05). There was no significant effect of the silane coupling agent on restoration repair survival. The repair of localized defects of the posterior composite restorations either with or without silane application is a conservative treatment option that may increase the clinical success of these restorations.

Post Caesarean Section Outcomes for Obstetric Valvular Heart Disease Patients at CHARLOTTE …..CMJAH

Background: Valvular heart disease presents a unique set of conditions during pregnancy and delivery with the potential of adverse outcomes complicated by prior interventions and anticoagulation. The aim of this study was to describe the profile and outcomes of obstetric valvular heart disease patients who delivered via caesarean section at Charlotte Maxeke Johannesburg Academic Hospital. Methods: A retrospective study was done using patient record files, anaesthetics forms and echocardiogram reports. The study period was a 5-year review from January 2016 to December 2020. Results: Sixty-nine patients were included. The mean age ± SD of the patients in this study was 30.1 ± 5.6. A total of 83% had gravidity of 1-3 and 90% parity of 0-2. Majority of patients (57%) had elective caesarean section. General anaesthesia was the most common mode used and majority of patients had fixed interval analgesia (FIA) mode of analgesia postoperatively. Approximately half of the patients (40.5%) were on anticoagulants. A significantly higher percentage of those who needed anticoagulation (46%) had poorer outcomes when compared to those who did not (7%), (P&lt;0.001). This was a univariable association between adverse maternal outcome and NYHA class and lack of use of anticoagulants [aOR 3.77, 95% CI 1.45 - 9.79, P=0.006 and aOR 0.11, 95% CI 0.018 - 0.67, P=0.017, respectively]. Low ejection fraction was univariably associated with adverse foetal outcome, uOR 0.94, 95% CI 0.90 - 0.99, P=0.032. One (1%) foetus demised. Conclusion: Patients were younger and in relatively good functional status. They carried the pregnancies to term. Patients did experience adverse outcome related to bleeding and arrythmias predominantly, but none demised. One neonate was lost. A structured care plan for these patients, based on a multidisciplinary approach, to afford prehabilitation is necessary.

Serum Amylase Level in Acute Organophosphorus Compound Poisoning in a Tertiary Level Hospital

Background: Organophosphorus compound (OPC) poisoning is an important clinical problem in the developing world and kills an estimated 3,00,000 people every year. In spite of high case fatality rate early and proper management is crucial to save the lives and alleviate the sufferings. Amylase level is an important biochemical marker, which is closely related to severity of acute OPC poisoning. Therefore, to assess Serum amylase level in acute organophosphorus compound poisoning in a tertiary level hospital was the objective of the study. Methods: This research was a hospital based descriptive cross-sectional study and was conducted at the inpatient department of Medicine in Dhaka Medical College. 50 Patient admitted in medicine department due to OPC poisoning and evidenced by history taking and physical examination were included in the study. Ethical issues were ensured properly. After written informed consent history and physical examination were done. Rest of the data were collected by interviewing each patient or from attendant of the patient by using a semi-structured questionnaire. Scoring of the severity were done by researcher himself by Peradeniya Organophosphorus Poisoning (POP) scale (Score range 0 to 11). Values of amylase level were collected from patient record file. All the Data was analysed by computer with the help of SPSS 16. Results: Out of a total of 50 patients, 24 (48%) were males and 26 (52%) were females. OPC poisoning was most frequent (52%) in age group 21-30 years. Mean age was 23.96 ± 6.071 SD. 96% (48) study population were Muslim and rest 4 % (2) were Hindus with diverse occupation. 86% population came from rural area whereas only 14% population reside in urban area. Among them suicidal attempts were seen significantly which was 96% and rest of them were accidental ingestion. Amylase level estimation were done in each case and 32 % (16) patient had elevated amylase level (&gt;100U/L) and 68% (34) patient had amylase level within normal limit. Mean amylase concentration was 62.2U/L (SD±18.77) and among the 16 patients who had elevated serum amylase level mean concentration was 376.56U/L (SD±266.124). Mean amylase level differed significantly between these two groups (p value &lt; 0.0001) estimated by one way ANOVA. Spearman Correlation and One way ANOVA both showed significant association between severity (assessed by POP scale) and elevated level of serum amylase (p value &lt;0.0001). Outcome analysis showed that 47 patients recovered and 3 patients died. Their mean hospital stay was 3.87 (±1.76) days and relationship between serum amylase level and duration of hospital stay and was found to be significant in chi-square analysis (p value- &lt;0.0001). Conclusion: Hyperamylasaemia in OPC poisoning can be used an important biomarker to assess the severity of the patient which may guide the clinicians for further management. J MEDICINE 2021; 22: 119-126

Barotrauma, invasive ventilation, and timing of tocilizumab as predictors of mortality along with inflammatory markers and comorbidities in critically ill COVID-19 patients: A retrospective study.

Barotrauma, invasive ventilation, and timing of tocilizumab as predictors of mortality along with inflammatory markers and comorbidities in critically ill COVID-19 patients: A retrospective study.

Clinical Profile and Predictors of Mortality in Neonates Born With Non-Immune Hydrops Fetalis: Experience From a Lower-Middle-Income Country.

IntroductionHydrops fetalis (HF) is a life-threatening condition in which a fetus has an abnormal collection of fluid in the tissue around the lungs, heart, abdomen, or under the skin. Based on its pathophysiology, it is classified into immune and non-immune types. With the widespread use of anti-D immunoglobulin, non-immune HF has become more common, with an incidence of one in 1,700-3,000 live births. A multitude of fetal diseases with various causes can lead to non-immune HF. Due to the recent advances in prenatal diagnostic and therapeutic interventions together with improved neonatal intensive care, the diagnosis and subsequent management of HF have been refined. However, HF is still associated with a high mortality rate. A recent assessment of the literature found that there is a lack of data on prognostic variables in neonates with HF from low- and middle-income countries. In light of this, we sought to establish the etiologic causes, predictors of mortality, and eventual fate of newborns born non-immune HF at the Aga Khan University Hospital, Karachi during the 10-year period spanning January 2009-December 2019 in this retrospective analysis.MethodologyFor this study, we collected data from the computerized database and patient record files at the hospital on all infants with non-immune HF. Demographic data, postnatal interventions, clinical and laboratory findings, outcomes, and the results of comparison between HF patients who died and those who survived were analyzed.ResultsThe incidence of non-immune HF at our hospital was 0.62/1,000 live births during the period under study, with 33 newborn babies diagnosed with non-immune HF from a total of 53,033 live-born deliveries. An etiologic factor was discovered in 17 (51.5%) neonates with non-immune HF while 16 (48.4%) were classified as those with unidentified etiology. The most common causes were cardiovascular and genetic syndromes, which resulted in 100% mortality. The overall mortality rate was 67%. The need for mechanical ventilation, surfactant therapy, and prolonged hospitalization were identified as independent risk factors of mortality.ConclusionOur study proves that the need for mechanical ventilation [moderate to severe hypoxic respiratory failure (HRF)] and prolonged hospitalization are strong predictors of poor outcomes in neonates with non-immune HF. Therefore, severe hydrops causing significant mortality can be anticipated based on the patients' respiratory status and the need for escalated oxygen support.