Record Department Research Articles

Determinants and Outcomes of COVID-19 during the Third Wave: A Cross sectional Study

Aim: The threat of COVID-19 has since been continuing as a recurring wave with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus changing it’s variant form frequently. This study was conducted with the aim to study the clinical profile, laboratory parameters, complications, and other outcomes of patients who were hospitalized with COVID-19 infection during the third wave in a tertiary care hospital in Manipur, India. Materials and methods: This is a single-centre retrospective study, and the necessary data were collected from the medical record department of RIMS (Regional Institute of Medical Sciences) Hospital, Imphal. In this study, the case records of COVID-19 positive patients who were hospitalized in the RIMS Hospital from 1st January 2022 to 31st March 2022 has been collected. Corresponding data on demographic profile, clinical symptoms, laboratory findings, complications, and clinical outcome has been collected and compared between patients deemed as non-severe and severe cases. Results and Conclusions: The analysis included 275 confirmed COVID-19 patients, and median age was 37 years and IQR (Inter quartile range) was (27-62) years; 41.5% (n = 114) were male, and 14% (n=16) deaths. Vaccination was significantly associated with the severity of disease among the older population. Aging, duration of hospitalization and d-dimer were independent factors increasing the risk of death due to COVID-19 (p < 0.001).

The Effectiveness of Electronic Medical Records (RME) On Hospital Service Quality

This study investigates The Medical Record Department (MRD) plays a pivotal role in the hospital administration framework at Shri Balaji Hospital, ensuring the efficient management and organization of patient health data. As an essential component of healthcare delivery, the MRD is responsible for maintaining accurate, comprehensive, and up-to-date records for all patients treated at the facility. This includes not only clinical data such as diagnosis, treatment plans, and surgical histories, but also administrative information vital for billing, insurance, and regulatory compliance. At Shri Balaji Hospital, the MRD operates under strict protocols to guarantee the confidentiality and security of patient records in accordance with legal and ethical standards. The department is crucial for the coordination of multidisciplinary care, as it facilitates the timely and accurate sharing of medical information between healthcare professionals, thus ensuring continuity of care and improving patient outcomes. The MRD also plays a significant role in hospital operations by supporting functions such as audits, quality control, and risk management. It ensures that the hospital adheres to national healthcare standards, including those set by accrediting bodies and government regulations. In this regard, the department’s meticulous record-keeping supports the hospital’s efforts in continuous quality improvement and patient safety initiatives.

Neck of Femur Fracture among Senior Citizen Managed with Hemiarthroplasty in a Tertiary Care Center in Nepal: An Observational Study

Introduction: Hemiarthroplasty is recognized as a prominent therapeutic option for neck of femur fracture without preexisting acetabular pathology; however, there are controversies in the scientific literature regarding this. The study aims to analyze epidemiology of patients sustaining neck of femur fracture and the functional outcomes following hemiarthroplasty. Methods: This is a observational cross-section study in a single tertiary care center of Nepal. Senior citizens, 60 years or above patients, with neck of femur fracture who underwent hemiarthroplasty from January 2017 to December 2022 were included in the study. Patient related data were retrieved from the medical record department of the hospital. A semi-structured proforma was designed which included patient demographic information, operative details and follow up evaluation using Modified Harris Hip Score. Ethical approval was obtained from the Institutional Review Committee (Reference number: 34/24). Results: The median Modified Harris Hip score for patients who received hemiarthroplasty for neck of femur fracture from January 2017 to December 2022 was 79 (IQR: 74-86), with 4 (9.30%) achieving excellent results, 19 (41.19%) good, 14 (32.56%) fair, and 6 (13.95%) poor outcomes. Conclusions: Hemiarthroplasty emerges as a valuable treatment for femoral neck fractures in senior citizens, aged 60 and above, providing good functional results.

ANALISIS PELEPASAN INFORMASI REKAM MEDIS KEPADA PIHAK KETIGA DI RS WAVA HUSADA

This study aims to examine the procedures for the release of medical records information to third parties at Wava Husada Hospital, ensuring compliance with applicable regulations to maintain the security and confidentiality of patient data. The research method used is a qualitative approach, including direct observation, in-depth interviews, and analysis of relevant documents. The results show that the procedure for releasing medical record information involves several important steps, including filling out an application form, submitting photocopies of official identification, and, if necessary, a notarized power of attorney. This process involves several related parties, such as the Medical Records Department, doctors or medical personnel, and ward staff working in inpatient or outpatient units. The main purposes for third-party requests for medical records information include insurance claims, transfer of treatment to ensure continuity of care, and administrative or consultation needs.

Diplomatic efforts of Russia on the eve of the First World War

The article shows chronology of measures being undertaken by Russian diplomats to resolve the conflict between the states of the opposing military-political blocs of “Entente” and “the Triple Alliance” on the eve of the First World War on the basis of the archive documents of the Department of History and Records of the Russian Foreign Ministry.

Navigating Hysterectomy Choices: A Retrospective Study On Non-Descent Vaginal And Total Abdominal Hysterectomy In Rural Women

Background The aim of the study is to compare the results of non-descent vaginal and total abdominal hysterectomy procedures done in women in a tertiary care hospital. A retrospective study done by collecting the data from medical records who underwent non-descent vaginal and total abdominal hysterectomy done in women with fibroids, adenomyosis, endometrial atypical hyperplasia and abnormal uterine bleeding. Materials and Methodology This was a retrospective study done by collecting the data from medical record department of the hospital for the period of 6 months from April 2024 to September 2024. The total record of the study consisted of 400 patients out of which 200 patients underwent total abdominal hysterectomy and the rest 200 underwent non-descent vaginal hysterectomy. Those patients were pre-operatively assessed by physical, clinical, radiological evaluations as well as biochemical tests. Results The data of a total of 200 NDVH patients and 200 TAH patients was analysed which showed that NDVH patients had lower parity and BMI, smaller uterine sizes, and were more likely to have surgery for abnormal uterine bleeding. Intraoperative outcome was found to be better for NDVH, with less blood loss and shorter operative duration. The post-operative complications were significantly lower in the NDVH group, resulting in shorter hospital stays. Overall, NDVH outcomes were found to be superior to TAH. Conclusion: The non-descent vaginal hysterectomy has much advantages when compared to total abdominal hysterectomy

CLINICOHISTOPATHOLOGICAL STUDY OF TESTICULAR TUMOURS IN DR. HASAN SADIKIN GENERAL HOSPITAL BANDUNG

Objective: The purpose of this research was to describe the clinical and histopathological characteristics of testicular tumours at Hasan Sadikin General Hospital (RSHS) between 2017-2021. Material & Methods: This research was a cross-sectional descriptive study examining the clinical and histopathological profiles of testicular tumours. The secondary data sources included medical records from the Department of Urology, Anatomic Pathology, Medical Records, and Hospital Information System (SIRS). The collected data covered age, ethnicity, clinical symptoms, site, stage, annual prevalence rate, and analyzed using Microsoft Excel. Results: There were 42 patients who had primary testicular tumour. The highest prevalence of testicular tumours at RSHS was in 2019 consist of 12(29%) patients and the lowest in 2020 were 6(14%) patients. Most patients were >35 years old amounting 19(45%) patients, Sundanese ethnicity were 29(69%) patients, and testicular enlargement revealed in 27(64%) patients. Majority patients were in stage 0/IB 36(86%) patients and occurred in unilateral testis which 34(80%) patients, with 3(7%) patients metastasized. The most common histopathological type was seminoma 18(43%) cases followed by prepubertal-type yolk sac tumour 9(21%) patients. Seminomas, and the fibroma-thecoma group were mostly in patients over 35 years old, while prepubertal-type yolk sac tumour was more commonly in children under 15 years old. Conclusion: Prevalence of testicular tumours increased from 2017 to 2019, then started to decrease in 2020. Histopathologically, seminoma was the most common type. These tumours were most commonly found in older individuals (>35 YO) and unilateral, diagnosed in stage 0/IB, and were mostly presented with enlargement of testis. Keywords: Testicular tumours, clinical features, histopathology

The Role of Early Mobilization in Outcome of Proximal Tibia Fractures Treated with Dual Plating

The management of bicondylar fracture of the proximal tibia is a challenging task and the aim of management is to achieve stable, painless and mobile joint and also to prevent the secondary degeneration of the joint. Open reduction and internal fixation with dual plating in such fractures is beneficial to address fracture fragments in different planes and also to achieve anatomical reduction under direct vision. It also allows stabilizing the fracture which helps in early mobilization of the patient. Early post-op rehabilitation is one the most important factor that play a vital role in outcome of the operated knees by preventing the post- operative stiffness and achieving good range of motion. This is a retrospective study conducted in Department of Orthopedic Surgery, Kurmitola General Hospital, Dhaka, Bangladesh from July to December 2022. Total 100 patients were included in the study. The functional outcome was evaluated according to Rasmussen scoring system. Mal-reduction of the articular surface was defined as an intra- articular step-off of at least 2 mm measured on scaled radiographs. Oldest patient was 71 years and youngest patient was 20 years old. Male were 79% and female were 21%. All the patients with bicondylar fracture treated with dual plating. Data was obtained from the Medical record department, indoor ward records, OPD registers and Operation theatre records. This study analyses the outcome of bicondylar proximal tibia fracture treated with dual plating in 100 patients. In our series we found 63 % excellent results and 28 % good results, while 7 % and 2% fair and poor outcome respectively. Fractures of proximal tibia are increasing with the increase in mechanization and increased road traffic in current world today. These fractures are more in men and those who use automobiles frequently for their outdoor ventures. Better preoperative planning in selection of approach can minimize the soft tissue injury and unnecessary periosteal stripping. ......

"Modernizing Cervical Cytology Screening with Liquid-Based Methods at Community-Level Hospitals: A Much-Needed Breakthrough for India".

Cervical cancer still ranks highest causing cancer-related morbidity and mortality in women in India. It is prudent to emphasise and implement cervical cancer screening strategies in the population efficiently and with regular intervals. Conventionally, PAP smear cytology is obtained by wooden spatula-Ayre's spatula. To improve sensitivity and specificity of the procedure and detection rate, better techniques of cells retrieval are available mainly liquid-based cytology (LBC), with help of cyto-brush. Literature has consistently proven efficiency of the technique and also reduced the proportion of inadequate sampling. We conduct this study to compare both the techniques and efficiency in a community hospital from data over 6years,to asses its role and benefits among Indian women. To compare conventional PAP smear and liquid-based cytology techniques analysing detection rates of positive lesions (CIN and also includes ASCUS and malignant), incidence of inadequate sampling, efficiency and cost-effectiveness. This is retrospective study at tertiary care obstetric hospital affiliated to government-run medical college in a metropolitan city of Mumbai. Data are retrieved from the Pathology Department, Medical Records Department, laboratory books and OPD registers. Pap's smear sampling was done mainly from OPD with all indications including routine tests as a part of gynaecological evaluation and screening, as well as for suspicious lesions on inspection. Group A consists women who had conventional PAP smear test for 3years (Dec 2015-Nov 2018) and Group B had women who benefited by LBC method for 3years (Dec 2018-Nov 2021). COVID-19 pandemic majorly affected the routine gynaecological OPD practice during 2021 as hospital was COVID facility hospital. Demographic parameters and presentations were comparable and similar. LBC methods have higher detection rate for positive reports, including ASCUS. But results were comparable in both groups and not statistically different. Importantly, incidences of inadequate sampling are reduced significantly with the LBC method. Unsatisfactory smears war high in Group A (7.752%) compared to Group B (3.712%) p-value 0.005, stating the increased rate of requirement of sending repeat smears, which involves higher engagement of time, resources and active participation from healthcare personnel. Good detection rates and significantly low rates of unsatisfactory smears make LBC rational and cost-effective. These are the times to switch to liquid-based cytology techniques, especially at the community level hospitals; in order to detect more women with cervical premalignant as well as malignant neoplastic lesions and to save lives. This can be made possible by emphasising the policy makers to incorporate these services through quality resources.

Pattern of occupational lung disease among industrial workers attending a medical college of Eastern India.

Occupational lung diseases (OLDs) contribute a significant proportion to the global burden of pulmonary morbidities but are grossly misdiagnosed due to the relative lack of attribution given to occupational exposures. Obstructive lung diseases are known to be associated with long-lasting disability and loss of earning capacity (LOEC) among workers in industrial setups, thus reducing nationwide productivity. In this context, the study aimed to find out the pattern of OLD and factors associated with the severity of it among patients in a tertiary care hospital. The study was a record-based secondary data analysis conducted in the Medical Records Department of a Medical College in Kolkata. A computerized database of patients attending Special Medical Board (SMB) examinations from the Department of Medical Records was utilized for data collection. A data abstraction format was constructed to collect information on pulmonary morbidity, occupational exposure, and sociodemographic and behavioral variables. Extracted data were analyzed in Microsoft Excel and Statistical Package for Social Sciences (SPSS) software. After a review of records, it was shown that 62.3% (66 out of 106 people) of the study subjects had an obstructive type of OLD, the most common being Jute Byssinosis. A negative correlation (Spearman's ρ = -0.136) was found between pulmonary function (FEV1/FVC) and LOEC (%) in the study subjects. In the multivariable logistic regression, exposure to organic dust was found to be significantly associated with worsened lung function {adjusted-Odd's Ratio (95% Confidence Interval) =3.11 (1.1-8.8), P value = 0.03}. OLD is an understated health issue, especially in an industrial diaspora of developing countries, like India. Healthcare facilities should utilize their resources properly for the advancement of medical surveillance in industries where organic dust is produced. Health education of the stakeholders regarding the consequences of OLDs and the benefits of preventive primary approaches will go a long way in alleviating the burden of disease.

Antibiotic Resistance Pattern of Bacteria Isolated from Clinical Specimens: A Hospital-Based Cross-sectional Study in Kathmandu, Nepal

Antibiotics are vital in combating infectious diseases, yet their increasing use fosters resistance. Antimicrobial resistance (AMR) is rising in Nepal due to factors such as indiscriminate, inappropriate, and inadequate antibiotic usage. This study aims to explore the association between demographic factors and the prevalence of specific bacterial strains within the surveyed population. Additionally, it seeks to determine the antibiotic resistance patterns of these bacteria. Antibiotic susceptibility or resistance data were retrieved from the Medical Records Department (MRD) of the Manmohan Memorial Medical College and Teaching Hospital (MMMCTH) in Kathmandu. Samples from patients with certain types of bacterial infections were included, with 56 from sputum reports, 46 from urine, and 8 from blood samples out of 110 retrieved. Analysis revealed that sputum samples were mostly from older males, while urine samples were mostly from females. Yet, gender did not significantly influence bacterial presence across sample types. Overall, Escherichia coli was the most prevalent bacterium (74%), followed by Salmonella typhi (25%), Staphylococcus aureus (25%), and Klebsiella pneumoniae (23%) isolated from different type of clinical samples. Altogether, 6-15 antibiotics were assessed for sensitivity, with 2–6 antibiotics showing sensitivity to blood bacteria, 1-6 antibiotics demonstrating sensitivity to sputum bacteria, and 3–8 antibiotics exhibiting sensitivity to urine bacteria. Many investigated antibiotics were resistant, only gentamicin exhibited sensitivity for all types of bacteria found in blood, sputum and urine. These findings underscore the importance of discerning bacterial resistance patterns for effective antimicrobial treatment selection.

Simulation based CPR Training of EMS Staff and its Utility in Managing Remote Patients at Tertiary Care Hospital of Central India

Abstract Introduction: AVBRH is 1500-bedded tertiary care hospital that caters to patients from areas within more than a 50 km radius. Emergency medical services (EMS) are established and frequently on the run. The EMS team has 10 basic life support (BLS) ambulances with 20 drivers and 20 paramedical staff. Daily, 3–5 highly critical patients who are in need of cardiopulmonary resuscitation (CPR) are transferred to the AVBRH hospital. The optimal medical care while transferring the patient to AVBRH hospital was unmonitored and without any benchmark. A low-risk simulation-based environment to practice can be valuable to maintain a wide array of skills. Effective and prompt delivery of expert instruction and guidance by a telesimulation is approved to be a beneficial approach in this setting. Training of EMS staff helps to improve patient care and satisfaction. Hence, we decided to undertake the simulation-based CPR training of the staff and correlate the outcome with existing mortality data of Medical record department (MRD). Objective: To optimize health care while transferring the patient to a tertiary hospital by BLS training and teleassisting. To see the impact of teaching and assisting on overall patient outcomes at the emergency department. Methodology: Forty EMS participants were enrolled and trained for 2 days. On day 1, they were trained in BLS, while on day 2, training in working as a team through simulation at school of virtual learning was done. They were trained to work as a team through simulated case scenarios with effective telecommunication while transferring the patient to the hospital. After training, these EMS staff were monitored and assisted according to the protocol of BLS by the emergency medicine department through telecommunication on the field for the next 3 months and reassessed again after the completion of 3 months. The following tabulated assessment format is used for EMS staff attending to the patient on the field. The prefield assessment on the same day of training and on postfield assessment after 3 months at school of virtual learning-simulation lab (SVL) was conducted. The data were gathered, tabulated, and analyzed for the percentage. Conclusion and Recommendation: Simulation-based teaching by a facilitator along with effective telesimulation creates an important link and gaps in the bridge between knowledge and technical skills. It has been found that overall patient care and performance of EMS staff was significantly improved; hence, recommendations for continuous assistance while transferring the patients are given. Training of the newly appointed EMS crew and the other available EMS services from the district should be aligned with assisted telecommunication services of AVBRH. Regular audit for quality improvement in EMS performance to be imparted.

Clinicopathological Profiles of and Patterns of Recurrence in Triple-Negative Breast Cancer Patients at a Cancer Care Center in Southern India.

Triple-negative breast cancer (TNBC) is characterized by the absence of expression of the estrogen receptor and the progesterone receptor by immunohistochemistry and human epidermal growth factor receptor overexpression absence either by immunohistochemistry or absence of amplification by fluorescence in-situ hybridization. TNBCs tend to have rapid growth when compared to other subtypes of breast cancer. TNBC is associated with higher histologic grade and more advanced disease at presentation. TNBC shows aggressive behavior and a high chance of recurrence. The aim was to analyze the clinicopathological profiles of and recurrence patterns in TNBC patients at our institute where most patients are from rural areas. This retrospective study was done at a tertiary cancer care center in Southern India where most patients come from rural backgrounds. Institutional Ethics Committee approval was obtained before the study. Case files of all breast cancer patients registered and treated at our center from 2014 to 2019 were retrieved from the medical record department and reviewed. Data from patients diagnosed with triple-negative breast cancer were identified and analyzed. Among the 841 breast cancer patients registered in our study, 150 (17.8%) were diagnosed with TNBC. The median age of diagnosis was 47 years. The majority of the patients, 89 (59.3%) presented with T2 tumors, and lymph node involvement was observed in 88 (58.6%) cases. Patient distribution based on cancer stage revealed that 77 (51.3%) had early-stage breast cancer (EBC), 70 (46.6%) had locally advanced breast cancer (LABC), and only three patients were categorized as having metastatic breast cancer (MBC). Modified radical mastectomy (MRM) was the preferred surgical approach in 144 (96%) cases, while only four patients underwent breast-conserving surgery (BCS). Adjuvant chemotherapy was administered to 119 (79.3%) patients, with 30 (20%) receiving both neoadjuvant and adjuvant chemotherapy (NACT/ACT). Among those who underwent NACT/ACT, a pathological complete response was observed in five (16.6%) patients out of 30 patients. The median duration of follow-up was 32.8 months. Among all patients, 36 (24%) experienced recurrence, with seven (19.4%) having local recurrence, 24 (66.6%) developing distant metastases, two patients experiencing both local and distant recurrence, and three patients developing contralateral breast cancer. Additionally, three patients experienced a second primary cancer. The most common sites of metastases were the lungs (14), followed by the bone (seven), the liver (four), and the brain (four). Recurrence rates were notably high within the first one to three years post-diagnosis. The median disease-free survival (DFS) of TNBC patients was estimated to be 65.6 months with no statistically significant difference (p=0.174) between EBC and LABC patients. TNBC is known for its heterogeneity. While it is often regarded as being more responsive to chemotherapy compared to other subtypes of breast cancer, TNBCs tend to behave aggressively, basically due to the underlying aggressive tumor biology. Though there are many treatment options for different subtypes of breast cancer, therapeutic modalities are limited for TNBCs. Aggressive tumor biology with limited treatment options denotes a gap in the development of novel strategies to improve outcomes in this subset of breast cancer patients.

Sociodemographic features, serum urea, creatinine and blood urea nitrogen/creatinine ratio in chronic kidney disease patients – A record based retrospective study

Objectives: Chronic kidney disease (CKD) is a progressive reduction in renal function. It is a condition where the kidneys lose their normal function, especially excretory and regulatory functions. Urea and creatinine are good indicators of a normal functioning kidney and an increase in the serum indicates kidney dysfunction. Blood urea nitrogen (BUN) and serum creatinine are widely accepted and the most common parameters to assess renal functions. The present study was done to assess the serum urea, creatinine levels, and BUN-creatinine ratio (BCR) in CKD subjects. Material and Methods: It was a record-based retrospective study. Data were obtained from the Medical Records Department. The patients diagnosed with CKD in August 2023 were extracted from the records. Details such as hospital ID, age, gender, and blood parameters such as serum urea, creatinine levels, and BCR were obtained. Categorical data were summarized as frequency (percentage). Results: It was found that the number of male patients was 24 (75.4%) and the number of female patients was 14 (24.6%). The majority of patients belonging to the age group category of 50–75 were 42 in number (73.6%). Abnormal creatinine values were found in 54 patients (94.7%). Conclusion: The present study found that male gender and age group 50–75 years were most commonly affected with CKD. The serum creatinine level was found to be predominately abnormal compared to the serum urea level and BCR.

Unit Cost Analysis of Haemodialysis Services By Activity Based Costing Approach as a Strategy For Increasing Hospital Profits

One of the catastrophic diseases that is the focus of health insurance financing is kidney failure. Haemodialysis is a type of kidney replacement therapy for chronic kidney disease using special equipment. One method of financing haemodialysis procedures is the National Health Insurance Program. Hospitals, as health service providers for JKN participants, have an interest in the INACBG rates. Based on the Regulation of the Minister of Health of the Republic of Indonesia Number 3 of 2023 concerning Health Service Tariff Standards in the Implementation of the Health Insurance Program, there are changes to tariffs for haemodialysis services. With the current tariff changes, single-use and re-use services are divided into two different tariffs. The research was conducted at Siloam Hospital Bali. The data taken is secondary data originating from the Financial Division of Siloam Hospital Bali, the Medical Records Department of Siloam Hospital Bali, and the Haemodialysis Department of Siloam Hospital Bali during the period January–April 2023. The data collected and the hypothesis formulated in this research will be tested using the MANOVA (Multivariate Analysis of Variance) test method, using SPSS software. The research results show that there is a significant difference in total costs for re-use and single-use haemodialysis services; there is a significant difference in the total INACBG rates per patient for re-use and single-use haemodialysis services and there is no significant difference in the difference between INACBG rates and total costs in re-use and single-use haemodialysis services.

Co-Twin Prognosis After Single Intrauterine Fetal Death at a Tertiary Care Hospital in India: A Retrospective Observational Study.

Twin pregnancy is associated with an increased risk of perinatal morbidity. Besides, if intrauterine death of a single twin occurs, it increases the morbidity of the surviving co-twin perinatally and postnatally. The objective of this study was to determine the incidence of single intrauterine fetal death (SIUFD) in a twin pregnancy and fetal outcome defined in dimensions according to the complications in the surviving co-twin. Data on twin pregnancies were collected retrospectively for a period of five years (from 2015 to 2019) from the labour room records of the Central Records Department (CRD) at the Postgraduate Institute of Medical Education and Research, Chandigarh, India. Cases with SIUFD were studied individually and neonatal follow-up was taken post delivery for up to three to eight years. Inclusion criteria were SIUFD in twin pregnancies after 14 weeks gestation, chorionicity pre-defined by early trimester ultrasonography. Exclusion criteria were higher-order pregnancy and monoamniotic twins. A total of1246 (4.273%) twin deliveries were conducted in the study period. Of these, 107 (8.587%) pregnancies had SIUFD with co-twin surviving in utero. Among these, 77 (72%) were dichorionic diamniotic (DCDA) twin pregnancies and 30 (28%) were monochorionic diamniotic (MCDA) twin pregnancies. The incidence of SIUFDwas 8.5%. Preterm birth was the most common complication observed in our study and was found in 53.5% and 58.3% of participants in DCDA and MCDA twins, respectively. Early neonatal death (within 24 hours of life) of the surviving twin was found in 29.2% monochorionic twins with SIUFD. SIUFD at < 28 weeks gestation led to a greater number of early neonatal deaths of surviving twins. The incidence of neurodevelopmental disorders (cerebral palsy, developmental delay, epilepsy) in our population after birth was 7.5% (n=93). Twin pregnancies with SIUFD have an increased incidence of preterm labour, increased neonatal death of the surviving twin, and neurodevelopmental disorders (cerebral palsy, developmental delay, epilepsy). Monochorionicity and SIUFD at <28 weeks gestation are associated with increased neonatal deaths in co-twin. The Incidence of neurodevelopmental disorders is not directly associated with chorionicity, but developmental delay is more profoundly seen in the monochorionic group.

A Descriptive Study on Existing System in Medical Records Department and Its Gap Analysis in Multispecialty Hospital

The study goals are to assess the efficiency of the current medical record system and the current system for keeping medical records and to stipulate the advantages and downsides of completely linking computerized health databases with patient anamnesis. The study analyse the existing system of documentation of the medical record department, to identify bottlenecks in the existing system of medical records, and to provide recommendations to overcome the bottlenecks and implement the required changes in the required medical records department. And to discover user responses to computerized health databases, whether users are satisfied or not with computerized health databases, and what is users' perceptions of computerized health databases through a data collection process that includes direct observation and questionnaires for MRD staff, doctors, and nurses. Therefore, the medical records department has become an important department in every hospital, providing a variety of services not only to patients but also to the hospital&amp; efficient operation, as well as playing a key role in health promotion and patient care quality.

A Retrospective Study Comparing the Surgical Results of Platysma Myocutaneous Flap, Buccal Pad of Fat, and Nasolabial Flap for Reconstruction After Fibrotomy in Cases of Oral Submucous Fibrosis.

To evaluate the effectiveness of nasolabial flap (NLF), a buccal pad of fat flap (BFP), and platysma myocutaneous flap (PMF) for reconstruction following fibrotomy for individuals with oral submucous fibrosis (OSMF). A retrospective study was conducted among patients diagnosed with grade III and IV OSMFin the Departmentof Oral and Maxillofacial Surgery at Sharad Pawar Dental Collegebetween January 2016 and August 2018. The essential patient information was obtained from the Medical Record Department (MRD) at Acharya Vinoba Bhave Rural Hospital (AVBRH), Datta Meghe Institute of Medical Sciences (DMIMS) Sawangi (Meghe) Wardha. The patients were categorized into three groups: the NLF, the BFP, and the PMF groups. Each group had 16 patients, and factors such as interincisal width, diminished burning sensation in the mouth, inter-commissure distance, and flap necrosis were compared pre- and post-operatively. Student's unpaired t-test and chi-square test were employed for statistical analysis. Mean interincisal mouth-opening increased from pre-operative 4.79 to 41.42 mm post-operatively in the NLF group, BFP group from 6 to 39.42 mm and in the PMF group from 9.26 to 39.34 mm with p value=0.0001. NLF group showed complete and partial resolution of the burning sensation of the mouth at 93.75% and 6.25%, BFP at 62.25% and 32.75% while in PMF it was 68.5% and 31.25% respectively. One year postoperatively 3.28 mm increase in inter-commissure width was observed in the NLF group with a marginal increase in the PMF group and a negligible increase in the BFP group. 18.75% partial flap necrosis was seen in BFP, 18.75% in the PMF group, and 6.25% in the NFL group. All the flaps are efficacious in treating OSMF, however, NLF stands ahead with its higher reliability owing to its excellent blood supply.

Male urethral stricture disease in a tertiary hospital in Port Harcourt, Nigeria: a five-year review of features, management and outcome.

Introduction: The aim is to assess the early impact of the current increased use of transurethral endoscopic procedures and emerging technologies on the management of urethral stricture disease (USD) in adult males at the University of Port Harcourt Teaching Hospital (UPTH), Nigeria. Material and Methods: The design of the study was cross-sectional and descriptive. Secondary data of patients treated between 01/6/2017 to 30/6/2022, with confirmed diagnosis of USD were used. Their registration numbers were used to access their records at the Health Records Department of the Hospital. Information obtained included sociodemographic data, aetiology, clinical features, types, sites and diagnostic tests of male USD, , uroflowmetry, urethral, and abdominopelvic ultrasonography, cystourethrography results, treatment methods, outcomes, complications and co-morbidities of USD. Data obtained were analyzed with simple statistics and presented. Results: Of 10,450 Urology patients 245 had USD. Data on 224 were found and analyzed. Their age profiles in years were mean, 45.7±18.6; age range 10-95. Married were 174 (77.68%). Urethral strictures were post inflammatory 126(56.25%); post traumatic 43.75%; bulbar,73(32.59%); bulbomembranous23.22%; posterior urethral 52(23.21%); penile 34(15.18%); and pan urethral 13, (5.18%). At presentation, 105 (46.88%) were hypertensive; 40.2% had UTI with Gram-negative bacilli. Recurrence of strictures occurred 6 months to one year after DVIU; 2 months to 6 years after urethroplasty. Non-compliance with schedules and follow-p occurred in 111 (49.55%) patients. Conclusion: USD prevalence was 24/1000 urology patients. UTIs were probably healthcare and prolonged catherization associated. Screening/review of service processes warranted. Lack of validated tools for measurement of outcome or dependent treatment variables made comparative studies unrealistic.

Evaluation of malaria cases among the outpatient visits to Ekiti State University Health Centre Ado-Ekiti, Nigeria: Pre- and Post-COVID incidence

The occurrence of COVID-19 pandemic that broke into the world in early 2020 was envisaged to affect existing diseases. This study evaluated the extent to which COVID-19 pandemic has affected malaria cases among the staff and students of Ekiti State University (EKSU), Ado-Ekiti, Nigeria. Clinical data involving malaria cases of outpatient visits to EKSU Health Centre during 2019 and 2021 were collected from the Record Department of the Health Centre for statistical analysis. Data were analyzed with SPSS version 20 with probability value of &lt; 0.05 as significant. Results showed that 1,246 people visited EKSU Health Centre as outpatients in 2019 and 1,243 in 2021. Only 642 (51.5%) had malaria in 2019 while 604 (48.6%) had malaria in 2021 with no significant difference (P= 0.143) in both years. The highest malaria cases was observed in April (57.7%) in 2019 and December (55.6%) in 2021. There was no significant difference in the malaria cases across the different months of both years. Malaria cases was higher in males than females in both years but without significant difference (P= 0.429). COVID-19 appears not to have effect on malaria cases in Ekiti State University Community Ado-Ekiti and possibly in other Nigerian universities.