Inflammatory fibroid polyp (Vanek's tumour): my worst nightmare in the emergency department.

A middle-aged woman presented in shock with bleeding per rectum for 2 days without any significant past medical or surgical illness. Abdominal sonography, oesophagogastroduodenoscopy and sigmoidocolonoscopy were unremarkable. Despite 6 units of blood transfusion, 3000 mL of plasma expanders and ionotropes, the arterial pressure gradually decreased.

The Blue Button Project: Engaging Patients in Healthcare by a Click of a Button.

The Blue Button project has become a way for many Americans to download their health records by just a click in any way that suits them, such as in print, on a thumb drive, or on their mobile devices and smartphones. Several organizations have developed and applied Blue Buttons on their websites to allow beneficiaries to securely access and view personal medical information and claims. The purpose of this literature review is to highlight the significance of the Blue Button project in the field of health information management.

'Single-Sitting' Laparoscopic Cholecystectomy and Endoscopic Removal of Common Bile Duct Stone for Cholelithiasis and Choledocholithiasis: a Feasibility Study.

'Single-sitting' laparoscopic cholecystectomy followed by endoscopic common bile duct clearance is emerging as a viable option for management of cholelithiasis and concomitant choledocholithiasis. The only disadvantage of the procedure is logistical since it requires co-ordination between two teams-the surgeons and the endoscopists. This limitation can be overcome in centres where both the procedures are performed by one team.

Learning from primary care meaningful use exemplars.

Background: Submission of clinical quality measures (CQMs) data are 1 of 3 major requirements for providers to receive meaningful use (MU) incentive payments under the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act. Some argue that CQMs are the most important component of MU. Developing an evidence base for how practices can successfully use electronic health records (EHRs) to achieve improvement in CQMs is essential and may benefit from the study of exemplars who have successfully implemented EHRs and demonstrated high performance on CQMs.

Comorbidity in patients with Dhat syndrome: a nationwide multicentric study.

Introduction: There are limited numbers of studies on Dhat syndrome. Major limitations of the existing literature are heterogeneous assessment methods used to describe the comorbidity and small sample size from isolated centers.

Aim: To assess comorbidity with a common methodology in patients with Dhat syndrome from multiple centers across India.

The effect of patient portals on quality outcomes and its implications to meaningful use: a systematic review.

Background: The Health Information Technology for Economic and Clinical Health (HITECH) Act imposes pressure on health care organizations to qualify for "Meaningful Use". It is assumed that portals should increase patient participation in medical decisions, but whether or not the use of portals improves outcomes remains to be seen.

Objective: The purpose of this systemic review is to outline and summarize study results on the effect of patient portals on quality, or chronic-condition outcomes as defined by the Agency for Healthcare Research and Quality, and its implications to Meaningful Use since the beginning of 2011.

Barriers over time to full implementation of health information exchange in the United States.

Background: Although health information exchanges (HIE) have existed since their introduction by President Bush in his 2004 State of the Union Address, and despite monetary incentives earmarked in 2009 by the health information technology for economic and clinical health (HITECH) Act, adoption of HIE has been sparse in the United States. Research has been conducted to explore the concept of HIE and its benefit to patients, but viable business plans for their existence are rare, and so far, no research has been conducted on the dynamic nature of barriers over time.

Objective: The aim of this study is to map the barriers mentioned in the literature to illustrate the effect, if any, of barriers discussed with respect to the HITECH Act from 2009 to the early months of 2014.

Factors associated with adoption of health information technology: a conceptual model based on a systematic review.

Background: The Health Information Technology for Economic and Clinical Health Act (HITECH) allocated $19.2 billion to incentivize adoption of the electronic health record (EHR). Since 2009, Meaningful Use Criteria have dominated information technology (IT) strategy.

Changing bacteriological profile and mortality trends in community acquired pneumonia.

There are very few and conflicting Indian data regarding the bacteriological etiology of community acquired pneumonia (CAP). Adding to this agony, there is no credible data from the eastern part of India. This is a cross-sectional study and descriptive in nature over a period of 1-year.

Modulating drug release profiles by lipid semi solid matrix formulations for BCS class II drug--an in vitro and an in vivo study.

The main objective of the study was to alter the dissolution profile of a practically insoluble Biopharmaceutics Classification System class II drug, aceclofenac, by formulating into lipid semisolid matrix (SSM) formulations using liquid filling technology in hard gelatin capsules, for both immediate and sustained release. SSM formulations of aceclofenac were prepared by melt fusion technique, using Gelucires (44/14, 50/13, 33/01 and 43/01), polyethylene glycols (4000 and 6000) and Poloxamer 188 at different levels. Role of additives like docusate sodium, Tween 80, Aerosil 200 and polyvinylpyrrolidone K-30 in enhancement of drug release was investigated.

Design and evaluation of the ONC health information technology curriculum.

Objective: As part of the Heath Information Technology for Economic and Clinical Health (HITECH) Act, the Office of the National Coordinator for Health Information Technology (ONC) implemented its Workforce Development Program, which included initiatives to train health information technology (HIT) professionals in 12 workforce roles, half of them in community colleges. To achieve this, the ONC tasked five universities with established informatics programs with creating curricular materials that could be used by community colleges. The five universities created 20 components that were made available for downloading from the National Training and Dissemination Center (NTDC) website.

Split flexor pollicis longus tendon transfer to A1 pulley for correction of paralytic Z deformity of the thumb.

Purpose: To test the hypothesis that split flexor pollicis longus (FPL) transfer to the A1 pulley will correct a thumb paralytic Z deformity and that the transfer can be subjected to early postoperative active mobilization protocol.

Methods: In a prospective trial, 19 consecutive thumbs with ulnar or combined ulnar and median nerve paralysis received split FPL transfer to the thumb A1 pulley and active mobilization of transfer after 48 hours. Outcomes were assessed by correction of Z deformity during pinch, tendon transfer insertion pullout during early active mobilization, range of motion at the thumb metacarpophalangeal and interphalangeal joints, and postoperative treatment time.

Biliary ascariasis--role of endoscopic intervention.

Aim: This study was undertaken to review the predisposing factors, presentation and management of patients diagnosed with biliary ascariasis while specifically emphasizing the role played by endoscopy.

Methods: We performed a retrospective analysis of nine patients diagnosed and admitted with biliary ascariasis at our center. The diagnosis was based on ultrasound findings and confirmed by detection of round worms in the biliary tract or the descending duodenum.

Evaluation of a wireless handheld medication management device in the prevention of drug-drug interactions in a Medicaid population.

Background: With the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act, widespread adoption of certain health information technologies, such as electronic health records (EHRs) and electronic prescribing (e-prescribing), is imminent. Drug-drug interaction (DDI) screening and medication history information are commonly incorporated into health information exchange systems to improve medical decision making, safety, and quality of care, but the value of these features is unclear.

Objective: To evaluate the effect of providing access to an early generation electronic medication management program with medication history accessible to prescribers via a wireless handheld personal digital assistant (PDA) device on the incidence of potential DDIs (i.

Hand kinematics: Application in clinical practice.

Pathological conditions of the hand consequent to injuries, paralysis, disease, arthritis and congenital difference results in loss or limitation of function, deformities, stiffness, inadequate power and poor position for pinch. The pathogenesis of deformities is influenced by bio-mechanical principles of joints and muscle function. The crippling impact of secondary changes due to edema, soft tissue contractures, muscle shortening and functional adaptations also have a mechanical basis.

Pattern of chest injuries in road traffic incident victims: a six-year retrospective study.

Introduction: The young are the most common victims of trauma and trauma is the leading cause of death in the first four decades of life. Injury accounts for more than 50% of deaths in children and is the third leading cause of death after cancer and atherosclerosis in all age groups. Thoracic trauma is one of the leading causes of death in all age groups and accounts for 25-50% of all traumatic injuries in the world.

Indian carp (Labeo rohita) gall bladder poisoning-report of four cases in a single family.

The ingestion of Indian carp gallbladder may result in transient hepatitis with subsequent acute renal failure. This case series also illustrates the importance of understanding the use and potential serious complications of alternative medicines. So fish gallbladder poisoning should be considered in unexplained acute renal failure in Chinese and Asian patients.

[Study on the function and influence of hi-tech on medical and health undertakings development in China].

The invention and use of science and technology have always been a double-edged sword. The paper analysed the function and influence of medical hi-tech on medical and health undertakings development in China, and gives opinions on how to treat medical hi-tech correctly, so as to provide reference for the use and supervision of medical hi-tech.

Why simulation can be efficient: on the preconditions of efficient learning in complex technology based practices.

Background: It is important to demonstrate learning outcomes of simulation in technology based practices, such as in advanced health care. Although many studies show skills improvement and self-reported change to practice, there are few studies demonstrating patient outcome and societal efficiency. The objective of the study is to investigate if and why simulation can be effective and efficient in a hi-tech health care setting.

The role of health informatics in clinical audit: part of the problem or key to the solution?

The concepts of quality assurance (for which clinical audit is an essential part), evaluation and clinical governance each depend on the ability to derive and record measurements that describe clinical performance. Rapid IT developments have raised many new possibilities for managing health care. They have allowed for easier collection and processing of data in greater quantities.

Algorithm for managing a baby with dusky soles.

We have been using dusky colour of the sole in newborns as proxy to cyanosis. An algorithm for management of dusky soles was developed presupposing that a baby can have dusky soles due commonly to hypothermia, hypoxaemia, or hypotension in isolation or in combination. Fifty-one consecutive babies were managed according to a predetermined algorithm based largely on clinical signs.