Showing papers by "Syed Iqbal Azam published in 2010"
TL;DR: An expert panel of clinicians and hospital managers reduced a long list of indicators to a manageable size, and this scorecard is now ready to be implemented by this hospital as a performance management tool for monitoring indicators, addressing measurement issues and enabling comparisons with hospitals in other settings.
Abstract: Balanced Scorecards (BSC) are being implemented in high income health settings linking organizational strategies with performance data. At this private university hospital in Pakistan an elaborate information system exists. This study aimed to make best use of available data for better performance management. Applying the modified Delphi technique an expert panel of clinicians and hospital managers reduced a long list of indicators to a manageable size. Indicators from existing documents were evaluated for their importance, scientific soundness, appropriateness to hospital's strategic plan, feasibility and modifiability. Panel members individually rated each indicator on a scale of 1-9 for the above criteria. Median scores were assigned. Of an initial set of 50 indicators, 20 were finally selected to be assigned to the four BSC quadrants. These were financial (n = 4), customer or patient (n = 4), internal business or quality of care (n = 7) and innovation/learning or employee perspectives (n = 5). A need for stringent definitions, international benchmarking and standardized measurement methods was identified. BSC compels individual clinicians and managers to jointly work towards improving performance. This scorecard is now ready to be implemented by this hospital as a performance management tool for monitoring indicators, addressing measurement issues and enabling comparisons with hospitals in other settings.
31 citations
Journal Article•
TL;DR: Sublingual misoprostol is as effective as vaginal misopostol for medical management of missed miscarriage but is associated with an increased risk of side effects especially an unpleasant taste.
Abstract: Objective: To compare the efficacy of sublingual and vaginal misoprostol in the medical management of missed miscarriage. Methods: Fifty women diagnosed as having missed miscarriage of gestational age less than 20 weeks were assigned randomly to receive 4008g of either sublingual or vaginal misoprostol every three hours, up to a maximum of five doses. The primary outcome measures were, complete evacuation of products of conception, mean induction to delivery time and the occurrence of side effects. Results: There was no significant difference in complete evacuation rates between the sublingual misoprostol and the vaginal misoprostol groups (52% vs. 48%, p = 0.571) mainly within the first 24 hours. Mean induction to delivery time was also similar for both groups (13.07 ± 6.95 hours for sublingual versus 13.29 ± 5.63 hours for vaginal group) as was the total number of doses required (4.44 ± 1.04 for sublingual versus 4.52 ± 0.96 for vaginal misoprostol). Side effects were seen in 18 women (72%) in the sublingual group compared to 5 women (20%) in the vaginal group (p < 0.001). The incidence of unpleasant taste was significantly higher in the sublingual group than in the vaginal group (60% versus 4%, p = < 0.001). Conclusion: Sublingual misoprostol is as effective as vaginal misoprostol for medical management of missed miscarriage but is associated with an increased risk of side effects especially an unpleasant taste (JPMA 60:113; 2010).
14 citations
TL;DR: Only marital status was found to be significantly associated with higher frequency of immediate VVR, where married donors were having higher odds as compared to singles, and married men are at more risk of experiencing VVR in the authors' population.
Abstract: Vasovagal reaction (VVR) is a very common adverse event related to blood donation. No study has been conducted in Pakistan to estimate the prevalence of VVR in blood donors. This study was conducted to estimate the prevalence of immediate VVR in blood donors of Karachi, Pakistan. The study was conducted in two blood banks of Karachi. Data regarding the development of immediate VVR were documented. The effect of blood donation on vital parameters like pulse rate, blood pressure (BP), temperature and respiratory rate was also observed. Six hundred and seventy-four blood donors were recruited. All the donors who consented were males. Weakness and dizziness were two most common symptoms which were reported by 91 (13.5%) and 73 (10.8%) of the participants, respectively. Out of 91 donors in whom signs and symptoms of immediate VVR were observed, a significant drop in systolic BP (13.5 +/- 2.5 mmHg) and decrease in pulse rate (13.3 +/- 3.6) were concurrently noted in 55 donors (8.2% of all the participants). There was lack of association of age, body mass index (BMI), estimated blood volume, ethnicity, educational status, profession and first time donation status with the frequency of VVR. Only marital status was found to be significantly associated with higher frequency of immediate VVR, where married donors were having higher odds as compared to singles. The prevalence of VVR in the blood donors at two blood banks of Karachi is at least 8.2%. Furthermore, married men are at more risk of experiencing VVR in our population.
11 citations