Abstract: Background: HIV virological failure still remains a problem in HV/AIDS treatment and care. This study aimed to describe the prevalence and identify the factors associated with viral non-suppression among HIV-positive adult patients on antiretroviral therapy in Woliso Town, Oromia, Ethiopia. Methods: A retrospective cross-sectional study was conducted among 424 HIV-positive patient’s attending antiretroviral therapy (ART) in Woliso Town during the period from August 25, 2020 to August 30, 2020. Data collected from patient medical records were entered into Epi Info version 2.3.2.1 and exported to SPSS version 21.0 for analysis. Logistic regression analysis was done to identify factors associated with viral load non-suppression, and statistical significance of odds ratios were declared using 95% confidence interval and p-value < 0.05. Results: A total of 424 patients were included in this study. The mean age (± SD) of the study participants was 39.88 (± 9.995) years. The prevalence of HIV viral load non-suppression was 55 (13.0%) with 95% CI (9.9-16.5). Second-line ART treatment regimen (Adjusted Odds Ratio (AOR) = 8.98, 95% Confidence Interval (CI): 2.64, 30.58) and routine viral load testing (AOR = 0.01, 95% CI: 0.001, 0.02) were significantly associated with virological non-suppression. Conclusion: Virological non-suppression was high, which hinders the achievement of the third global 95 target. The second-line regimen and routine viral load testing were significantly associated with virological non-suppression. It suggests the need to assess the effectiveness of antiretroviral drugs for epidemic control. It also clearly shows the need to decentralize third-line ART treatment for those patients in need.
Abstract: Poor system use, including inappropriate design of health information systems, causes difficulties in communication with patients and increased time spent by healthcare professionals in recording the necessary health information for medical records. System features like pop-up reminders, complex menus, and poor user interfaces can make medical records far more time consuming than paper cards as well as affect decision-making processes. Although errors associated with health information and their real and likely effect on the quality of care and patient safety have been documented for many years, more research is needed to measure the occurrence of these errors and determine the causes to implement solutions. Therefore, the purpose of this paper is to identify data integrity challenges in hospital information systems through a scoping review and based on the results provide recommendations on how to manage these. Only 34 papers were found to be most suitable out of 297 publications initially identified in the field. The results indicated that human and computerized systems are the most common challenges associated with data integrity and factors such as policy, environment, health workforce, and lack of awareness attribute to these challenges but if measures are taken the data integrity challenges can be managed.
Abstract: In an access-control situation, the role of a user determines whether a data request is appropriate. This paper combines vetted web mining and logic modeling to build a lightweight system for determining the role of a health care provider based only on their prior authorized requests. The model identifies provider roles with 100% recall from very little data. This shows the value of vetted web mining in AI systems, and suggests the impact of the ICD classification on medical practice.
Abstract: Vaginal stenosis is a common side effect associated with pelvic radiotherapy in cervical cancer patients which contributes negatively to woman’s health and prevents adequate vaginal/cervical examination. Vaginal dilation with a dilator is routine practice and is internationally advocated as a prophylactic measure to preserve vaginal patency. This retrospective study was carried out with the aim to know the usefulness of vaginal dilation following pelvic radiation therapy in cervical cancer patients in India. Data from medical records of 183 cervical cancer patients, which met the study criteria, were collected related to the stage of the disease, treatment received, commencement period of dilation post radiation therapy, sexual status and side effects associated to dilation practice. Data related to vaginal dimensions as per the length of insertion of a small, medium and large dilator were collected on regular follow-ups until 36 months and/or more. Vaginal dimensions as measured with the length of medium dilator insertion were used for analysis of dilation therapy results using paired t-test. Patients who underwent vaginal dilation with dilator maintained vaginal patency, also the mean vaginal length significantly increased, from 8.02 cm ± 2.69 to 9.96 ± 2.89 cm with a p value
Abstract: Background: Traditional chronic disease management did not pay attention to effects of geographic factors on the compliance of treatment regime, which resulted in geographic inequality in outcomes of chronic disease management. This study aims to examine the geographic distribution and clustering of quality indicators of diabetes care. Method: We first extracted address, demographic information and quality of care indicators (number of visits, complications, prescription and laboratory records) of patients with diabetes for 2014 from medical information system in a medical center in Tainan City, Taiwan, and the patients’ addresses were transformed into district- and village-level data. We then compared the differences of geographic distribution and clustering of quality of care indicators between districts and villages. Despite the descriptive results, rate ratios and 95% confidence intervals (CI) were estimated for indices of care in order to compare the quality of diabetes care among different areas. Results: A total of 23,588 patients with diabetes were extracted from the hospital data system; whereas 12,716 patients’ information and medical records were included to the following analysis. More than half of the subjects in this study were male and between 60-79 years old. Furthermore, the quality of diabetes care did indeed vary by geographical levels. Thru the smaller level, we could point out clustered areas more specifically. Fuguo Village (of Yongkang District) and Zhiyi Village (of Sinhua District) were found to be “hotspots” for nephropathy and cerebrovascular disease; while Wangliau Village and Erwang Village (of Yongkang District) would be “coldspots” for lowest proportion of ≥80% compliance to blood lipids examination. On the other hand, Yuping Village (in Anping District) was the area with the lowest proportion of ≥80% compliance to all laboratory examination. Conclusion: In spite of examining the geographic distribution, calculating rate ratios and their 95% CI could also be a useful and consistent method to test the association. This information is useful for health planners, diabetes case managers and other affiliate practitioners to organize care resources to the areas most needed.
Abstract: Access to advanced medical services has been one of the medical challenges faced by our present society especially in distant geographical locations which may be inaccessible. Then the need for telemedicine arises through which live videos of a doctor can be streamed to a patient located anywhere in the world at any time. Patients’ medical records contain very sensitive information which should not be made accessible to unauthorized people in order to protect privacy, integrity and confidentiality. This research work focuses on a more robust security measure which is biometric (fingerprint) as a form of access control to data of patients by the medical specialist/practitioner.
Abstract: Introduction: To update ourselves and understand the
concept of latest electronic formats available for Health care
providers and how it could be used and developed as per standards.
The idea is to correlate between the patients Manual Medical Records
keeping and maintaining patients Electronic Information in a Health
care setup in this world. Furthermore, this stands with adapting to the
right technology depending upon the organization and improve our
quality and quantity of Healthcare providing skills. Objective: The
concept and theory is to explain the terms of Electronic Medical
Record (EMR), Electronic Health Record (EHR) and Personal Health
Record (PHR) and selecting the best technical among the available
Electronic sources and software before implementing. It is to guide
and make sure the technology used by the end users without any
doubts and difficulties. The idea is to evaluate is to admire the uses
and barriers of EMR-EHR-PHR. Aim and Scope: The target is to
achieve the health care providers like Physicians, Nurses, Therapists,
Medical Bill reimbursements, Insurances and Government to assess
the patient’s information on easy and systematic manner without
diluting the confidentiality of patient’s information. Method: Health
Information Technology can be implemented with the help of
Organisations providing with legal guidelines and help to stand by
the health care provider. The main objective is to select the correct
embedded and affordable database management software and
generating large-scale data. The parallel need is to know how the
latest software available in the market. Conclusion: The question lies
here is implementing the Electronic information system with
healthcare providers and organization. The clinicians are the main
users of the technology and manage us to “go paperless”. The fact is
that day today changing technologically is very sound and up to date.
Basically, the idea is to tell how to store the data electronically safe
and secure. All three exemplifies the fact that an electronic format
has its own benefit as well as barriers.
Abstract: Estimation of the magnitude and causes of poisoning
was the objective of the current study. A retrospective study of
medical records of all poisoning children admitted to Benghazi
Children Hospital in Libya from January 2008 up to December 2010.
Number of children admitted was 244; the age ranged from less than
one to 13 years old. Most of cases were admitted with mild symptom
and the majority of them were boys. Only few cases admitted to
intensive care unit and there was no mortality recorded through the
period of study. Age group 1 to 3 years (50.8%) had the highest
frequency of admission and the peak of admission was during
summer. The most common cause of admission was due to ingestion
of medication (53.69%), House hold product exposure (26.64%) was
the second causes of admission while, 19.67% of admissions were
due to Food poisoning. Almost all admitted cases were accidental and
medicines were the most consumed substances in addition, improper
storage of toxic agents were the first risk factor of poisoning. Present
results indicated that, children poisoning seems to be a common
pediatric care problem which need to control and prevent.
Abstract: Data mining has been used very frequently to extract
hidden information from large databases. This paper suggests the use
of decision trees for continuously extracting the clinical reasoning in
the form of medical expert-s actions that is inherent in large number
of EMRs (Electronic Medical records). In this way the extracted data
could be used to teach students of oral medicine a number of orderly
processes for dealing with patients who represent with different
problems within the practice context over time.
Abstract: Nosocomial (i.e., hospital-acquired) infections
(NI) is a major cause of morbidity and mortality in hospitals. NI
rate is higher in intensive care units (ICU) than in the general
ward due to patients with severe symptoms, poor immunity,
and accepted many invasive therapies. Contact behaviors
between health caregivers and patients is one of the infect
factors. It is difficult to obtain complete contact records by
traditional method of retrospective analysis of medical records.
This paper establishes a contact history inferential model
(CHIM) intended to extend the use of Proximity Sensing of
rapid frequency identification (RFID) technology to
transferring all proximity events between health caregivers and
patients into clinical events (close-in events, contact events and
invasive events).The results of the study indicated that the
CHIM can infer proximity care activities into close-in events
and contact events.
The infection control team could redesign and build optimal
workflow in the ICU according to the patient-specific contact
history which provided by our automatic tracing system.
Abstract: In recent years image watermarking has become an
important research area in data security, confidentiality and image
integrity. Many watermarking techniques were proposed for medical
images. However, medical images, unlike most of images, require
extreme care when embedding additional data within them because
the additional information must not affect the image quality and
readability. Also the medical records, electronic or not, are linked to
the medical secrecy, for that reason, the records must be confidential.
To fulfill those requirements, this paper presents a lossless
watermarking scheme for DICOM images. The proposed a fragile
scheme combines two reversible techniques based on difference
expansion for patient's data hiding and protecting the region of
interest (ROI) with tamper detection and recovery capability.
Patient's data are embedded into ROI, while recovery data are
embedded into region of non-interest (RONI). The experimental
results show that the original image can be exactly extracted from the
watermarked one in case of no tampering. In case of tampered ROI,
tampered area can be localized and recovered with a high quality
version of the original area.
Abstract: Transferring patient information between medical care
sites is necessary to deliver better patient care and to reduce medical
cost. So developing of electronic medical records is an important trend
for the world.The Continuity of Care Document (CCD) is product of
collaboration between CDA and CCR standards. In this study, we will
develop a system to generate medical records with entry level based on
CCD template module.