Context Access to real-time data that provide accurate and timely information about the status and extent of disease spread could assist management of the COVID-19 pandemic and inform decision-making. Aim To demonstrate our experience with regard to implementation of technical and architectural infrastructure for a near real-time electronic health record-based surveillance system for COVID-19 in Iran. Method This COVID-19 surveillance system was developed from hospital information and electronic health record (EHR) systems available in the study hospitals in conjunction with a set of open-source solutions; and designed to integrate data from multiple resources to provide near real-time access to COVID-19 patients’ data, as well as a pool of health data for analytical and decision-making purposes. Outcomes Using this surveillance system, we were able to monitor confirmed and suspected cases of COVID-19 in our population and to automatically notify stakeholders. Based on aggregated data collected, this surveillance system was able to facilitate many activities, such as resource allocation for hospitals, including managing bed allocations, providing and distributing equipment and funding, and setting up isolation centres. Conclusion Electronic health record systems and an integrated data analytics infrastructure are effective tools to enable policymakers to make better decisions, and for epidemiologists to conduct improved analyses regarding COVID-19. Implications Improved quality of clinical coding for better case finding, improved quality of health information in data sources, data-sharing agreements, and increased EHR coverage in the population can empower EHR-based COVID-19 surveillance systems.
The aim of this study was to describe three neglected pregnancy at the time of bariatric surgery (BS) who had negative pregnancy test before surgery and underwent single-anastomosis gastric bypass surgery in obesity clinic in Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. The first case was a 38 years old woman with BMI of 47.1 suffering from nausea and vomiting one month after surgery that medical treatment did not work and it was found positive βHCG test as and 13W + 6D fetus in sonography. The second case was a 30 years old woman with BMI of 46.2 suffering uterus bleeding four months after surgery. The third case was a 32 years old woman with BMI of 44.6 with suffering from resistant nausea and vomiting, epigastric pain, and delayed mense three month after surgery. These cases show the necessity of βHCG test at the time of bariatric surgery for childbearing females.
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