Completeness Analysis of Completeness Filling and Time of Returning The Medical Record for Inpatient Patients at Regional General Hospital of Makassar City

At Makassar City Hospital, one of the service indicators that has not been achieved is in incomplete medical record files and medical record files that are returned more than 2x24 hours after service. This study aims to analyze the implementation of the completeness of filling in and the timeliness of returning inpatient medical record files at the Makassar City Hospital. This type of research is mixed methods research. The study design used a cross-sectional approach. The study was conducted in September - October 2020. The results showed that the implementation of completeness of filling in and the timeliness of returning medical record files was still low, this has led to the accumulation of medical record files in the treatment room and delays in returning the files of inpatients to the medical record installation of the City Hospital Makassar. Training on the implementation of medical records has not been comprehensive for all officers at the Makassar City Hospital. The result of the delay in returning the documents is the delay in payment of insurance claims to the hospital. Accumulation of medical records in the treatment room from incomplete medical records and returned to the treatment room. Health workers who forget to fill in complete medical records are only given a sanction in the form of a warning during a meeting with the medical committee. Availability of SOP on filling and returning medical record files at the hospital. The facilities and infrastructure in the implementation of medical records are still insufficient for medical record employees at Makassar City Hospital. It is recommended that the hospital improve the implementation of the completeness and timeliness of returning medical record files, provide incentives or rewards for completing filling in, increase the number of computers and expand the room in the medical record installation, and review the medical record format at Makassar City Hospital

Effect of Different Lysine Regimens on Growth, Productive and Reproductive Performance of Indigenous Aseel Varieties

The indigenous Aseel possess high ultimate weight, strong physique, stamina as well as resistance against diseases and is equally adjustable in all environments. Due to the transitional changes of housing system from confined to open-sided, broilers could not accomplish well in open-sided poultry farms and about 20,000 trivial poultry farmers in the Punjab province of Pakistan could not endure their poultry businesses. Although Aseel is a slow grower with poor production, it can be used as a meat type bird and a better alternate of broiler if its growth, productive and reproductive performance is enhanced. However, little attention has been paid uptill now on this native breed of Pakistan to improve its productivity. This research was conducted to improve the overall performance of Aseel. It was hypothesized that the strategic use of lysine may improve the performance of native Aseel chicken. The objective of present research was to maximize the early growth and its subsequent effects on development, age at market, productive and reproductive performance in varieties of indigenous Aseel namely Lakha, Mianwali, Mushki and Peshawari by supplementing them with different dietary lysine regimens. For this purpose, 240 day-old Aseel chicks with 60 birds from each variety were randomly selected and secured from Avian Research and Training Centre, UVAS, Lahore. These birds were divided into 3 equal groups A, B and C and were subjected to 3 different dietary lysine regimens i.e., L1, L2 and L3 during their initial growth period. L1 lysine regimen containing 1.3 % lysine, was offered to group A from 0-6th week in 1 phase, L2 lysine regimen contained 1.4 and 1.2 % lysine and it was offered to group B in 2 phases, i.e., 1.4% from 0-3rd week and 1.2% from 4-6th week. L3 lysine regimen contained 1.5, 1.3 and 1.1% lysine, wherein, 1.5% was offered from 0-2nd week, 1.3% from 3-4th week and 1.1% lysine from 5-6th week, to group C. These birds having factorial arrangement of 3 (lysine regimens) × 4 (varieties) × 20 (replicates) with one bird in each were placed in blocks and maintained under standard conditions at Indigenous Chicken Genetic Resource Centre, UVAS, Lahore. Weekly data of growth (week 0-6), rearing (week 7-21), production and reproduction performance (week 24-43) was noted. The data after analysis of homogeneity and uniformity, were exposed to two-way ANOVA (Analysis of Variance) as a Randomized Complete Block Design having dietary lysine regimens, Aseel varieties (blocking agents) and interactions among them as main effects. Treatment means were compared through Duncan’s Multiple Range Test (Duncan, 1955). All the tabulated data have been mentioned as means and their standard errors and the results were considered significant at P≤0.05. The findings of this study showed significant (P≤0.05) differences among growth parameters including body weight, weight gain, feed conversion ratio and feed efficiency of birds fed with L1, L2 and L3 lysine regimen, wherein, the overall growth performance was found better in Mushki variety of Aseel. The birds fed on L3 lysine regimen had significantly higher serum glucose, total protein, globulin, high density lipoprotein, triglycerides and antibody titer against Newcastle Disease Virus and Infectious Bronchitis Disease Virus, while, Lakha and Peshawari varieties presented an overall improved picture of their blood biochemical profile and immune response against NDV and IBV. Moreover, L3 lysine regimen was found to be the best for improving the slaughter and carcass characteristics including weight of head, shanks, lungs, liver, gizzard, heart, and carcass yield comprising percent weight of breast and thigh. For production performance evaluation, 96 pullets (24 from each of the four varieties) and 12 cockerels (3 from each of the four varieties) were randomly selected from existing stock and placed in three-tiered identical cage units each with a space of 1.5 square feet. Among production parameters, cumulative egg number per hen, cumulative egg mass, egg weight, Hen day production percent and Hen house production percent were significantly (P≤0.05) higher in birds reared under L3 than L2 and L1 lysine regimens. Mushki variety showed highest egg production and persistency (between 28th to 35th week) than Peshawari, Mianwali and Lakha varieties and the birds reared under L3 were found to be more economical than L2 and L1 lysine regimens. L3 lysine regimen also showed significantly (P≤0.05) increased average egg weight, length, width, surface area and egg volume. Among reproductive performance parameters, it was found that birds fed on L3 lysine regimen had higher fertility, hatchability, hatch of fertile (%), hatched chick weight (g) while decreased clear egg, dead germ and dead in shell (%). The body weights of day-old chicks i.e., first progeny of the parent flock, also revealed superiority for L3 lysine regimen where newly hatched chicks of Mianwali variety were heavier in body weight. The findings of reproductive performance also concluded that lysine supplemented as in L3 regimen was superior even in its subsequent impact. Conclusively, it is stated that indigenous Aseel varieties subjected to L3 dietary lysine regimens had better early growth, early age at market, better feed conversion ratio and improved productive as well as reproductive performance. This would ultimately help bring around the open-sided poultry farms and the poor poultry farmers back into their business with minimum inputs and high turnover resulting in the revival of rural agro-poultry activity in Pakistan.