ABSTRACT
Objective: To assess effect of [specialty oriented HMS software] on [quality of EMRs]
Study Design: Comparative interventional study
Place and Duration of Study: Obstetrics Out Patient Department [OPD] of Pak Emirates Military Hospital [PEMH] Rawalpindi and Combined Military Hospital [CMH] Lahore, from Apr 2015 to Mar 2018
Material and Methods: The study began in 2015 with a baseline survey of quality of EMRs produced by generic HMS software in vogue. We used an observational checklist derived from hospital SOPs including 12 mandatory EMR fields. We then collaborated with IT experts to develop and implement a specialty oriented test-HMS in obstetrics OPD, PEMH. After 6 months, quality of EMRs generated by test-HMS was assessed using same method. We cross tabulated the quality of pre and post intervention EMRs. EMR quality among individual EMR fields was also compared for each software. In 2018, we assessed quality of EMRs at tertiary care hospital, a year after the official launch of customized new-HMS software in the hospital
Results: Both the test-HMS and new-HMS had a statistically significant effect in improving quality of EMRs. A statistically significant variation was also observed among EMR quality of individual fields irrespective of the software being used
Conclusion: Customization of HMS improves the quality of EMRs but there may be other factors effecting EMR quality besides customization of HMS. We need to Identify and address those factors to attain true benefits of HMS
ABSTRACT
Objective: To determine the frequency of Von Willebrand disease [vWD] in patients of heavy menstrual bleeding [HMB]
Study Design: Hospital based cross sectional study
Place and Duration of Study: Study was conducted at the Gynecology and Obstetrics department, Military Hospital, Rawalpindi in collaboration with Haematology Department of Armed Forces Institute of Pathology [AFIP] Rawalpindi, from Jul to Dec 2015
Material and Methods: Women presenting with HMB were enrolled in the study after informed consent. HMB was defined as cyclical bleeding at normal intervals but patient is using more than 5 pads per day or increase in duration 8/28 or more for at least last 06 months. Venous blood samples were taken and screened for the hemoglobin level [Hb], platelet count, prothrombin time [PT], activated partial thromboplastin time [aPTT] and Von Willebrand antigen [vWF:Ag] in addition to bleeding time [BT] at the Armed Forces Institute of Pathology [AFIP]. The demographic details [age, age at menarche], clinical features [menstrual history, quantity of bleeding] and laboratory findings were recorded on the study proforma
Results: A total of 200 patients were enrolled in this study with mean age of 32.3 +/- 8.5 years. Mean flow of menstrual blood was 9.8 +/- 2.5 pads / day. Mean Hb% was 8.1 +/- 1.4 g/dl. Twenty nine [14.5%] patients were having low level of vWF:Ag
Conclusion: There is high frequency of von Willebrand disease among females presenting with heavy menstrual bleeding in our set up. Therefore all patients with heavy menstrual bleeding except those with obvious causes like multiple fibroid should be screened for von Willebrand disease
ABSTRACT
To measure the effects of calcium supplements and exercise on bone mineral density in women between 35-70 years. Quasi experimental study. The study was conducted in the department of gynecology Combined Military Hospital Abbotabad, from July 2004 to June 2006. Based upon bone mineral densities T score 39 patients were assigned to group A [osteopenic] and 20 patients to group B [osteoprotic]. Both groups were subdivided into I and II groups. The cases in group-IA and group-IIA were given calcium Ossonate 800 mg in two divided doses. Whereas, the cases in group-IB and group-IIB were advised to take dietary calcium in the form of two glasses milk [300 mg calcium/glass] and one hour brisk walk daily. Better improvement in bone mass density was noted in group I-B patients as compared to other groups. In osteopenia a combination of dietary supplementation and brisk walk is beneficial in maintaining or improving bone mineral density. In osteoporosis, the more severe form of the disease, simple calcium supplements or dietary calcium supplementation with exercise are not helpful