Abstract: This paper presents a system designed for wireless acquisition, the recording of electrocardiogram (ECG) signals and the monitoring of the heart’s health during surgery. This wireless recording system allows us to visualize and monitor the state of the heart’s health during a surgery, even if the patient is moved from the operating theater to post anesthesia care unit. The acquired signal is transmitted via a Bluetooth unit to a PC where the data are displayed, stored and processed. To test the reliability of our system, a comparison between ECG signals processed by a conventional ECG monitoring system (Datex-Ohmeda) and by our wireless system is made. The comparison is based on the shape of the ECG signal, the duration of the QRS complex, the P and T waves, as well as the position of the ST segments with respect to the isoelectric line. The proposed system is presented and discussed. The results have confirmed that the use of Bluetooth during surgery does not affect the devices used and vice versa. Pre- and post-processing steps are briefly discussed. Experimental results are also provided.
Abstract: This study was aimed to measure effective transverse
relaxation rates (R2*) in the liver and muscle of normal New Zealand
White (NZW) rabbits. R2* relaxation rate has been widely used in
various hepatic diseases for iron overload by quantifying iron contents
in liver. R2* relaxation rate is defined as the reciprocal of T2*
relaxation time and mainly depends on the constituents of tissue.
Different tissues would have different R2* relaxation rates. The signal
intensity decay in Magnetic resonance imaging (MRI) may be
characterized by R2* relaxation rates. In this study, a 1.5T GE Signa
HDxt whole body MR scanner equipped with an 8-channel high
resolution knee coil was used to observe R2* values in NZW rabbit’s
liver and muscle. Eight healthy NZW rabbits weighted 2 ~ 2.5 kg were
recruited. After anesthesia using Zoletil 50 and Rompun 2% mixture,
the abdomen of rabbit was landmarked at the center of knee coil to
perform 3-plane localizer scan using fast spoiled gradient echo
(FSPGR) pulse sequence. Afterwards, multi-planar fast gradient echo
(MFGR) scans were performed with 8 various echo times (TEs) to
acquire images for R2* measurements. Regions of interest (ROIs) at
liver and muscle were measured using Advantage workstation.
Finally, the R2* was obtained by a linear regression of ln(sı) on TE.
The results showed that the longer the echo time, the smaller the signal
intensity. The R2* values of liver and muscle were 44.8 ± 10.9 s-1 and
37.4 ± 9.5 s-1, respectively. It implies that the iron concentration of
liver is higher than that of muscle. In conclusion, the more the iron
contents in tissue, the higher the R2*. The correlations between R2*
and iron content in NZW rabbits might be valuable for further
exploration.
Abstract: Adequate analgesia following caesarean section
decreases morbidity, hastens ambulation, improves patient outcome
and facilitates care of the newborn. Intrathecal magnesium, an
NMDA antagonist, has been shown to prolong analgesia without
significant side effects in healthy parturients. The aim of this study
was to evaluate the onset and duration of sensory and motor block,
hemodynamic effect, postoperative analgesia, and adverse effects of
magnesium or fentanyl given intrathecally with hyperbaric 0.5%
bupivacaine in patients with mild preeclampsia undergoing caesarean
section. Sixty women with mild preeclampsia undergoing elective
caesarean section were included in a prospective, double blind,
controlled trial. Patients were randomly assigned to receive spinal
anesthesia with 2 mL 0.5% hyperbaric bupivacaine with 12.5 μg
fentanyl (group F) or 0.1 ml of 50% magnesium sulphate (50 mg)
(group M) with 0.15ml preservative free distilled water. Onset,
duration and recovery of sensory and motor block, time to maximum
sensory block, duration of spinal anaesthesia and postoperative
analgesic requirements were studied. Statistical comparison was
carried out using the Chi-square or Fisher’s exact tests and
Independent Student’s t-test where appropriate. The onset of both
sensory and motor block was slower in the magnesium group. The
duration of spinal anaesthesia (246 vs. 284) and motor block (186.3
vs. 210) were significantly longer in the magnesium group. Total
analgesic top up requirement was less in group M. Hemodynamic
parameters were similar in both the groups. Intrathecal magnesium
caused minimal side effects. Since Fentanyl and other opioid
congeners are not available throughout the country easily,
magnesium with its easy availability and less side effect profile can
be a cost effective alternative to fentanyl in managing pregnancy
induced hypertension (PIH) patients given along with Bupivacaine
intrathecally in caesarean section.
Abstract: A group of 10 dogs (group A) with Periodontal Disease in the third stage, were subjected to regenerative therapy of periodontal tissues, by use of nano hydroxy apatite (NHA). These animals induced by general anesthesia, where treated by ultrasonic scaling, root planning, and at the end by a mucogingival flap in which it was applied NHA. The flap was closed and sutured with simple steps. Another group of 10 dogs (group B), control group, was treated only by scaling and root planning. No patient was subjected to antibiotic therapy. After three months, a check was made by inspection of the oral cavity, radiography and bone biopsy at the alveolar level. Group A showed a total restitutio ad integrum of the periodontal structures, and in group B still mild gingivitis in 70% of cases and 30% of the state remains unchanged. Numerous experimental studies both in animals and humans have documented that the grafts of porous hydroxyapatite are rapidly invaded by fibrovascular tissue which is subsequently converted into mature lamellar bone tissue by activating osteoblast. Since we acted on the removal of necrotic cementum and rehabilitating the root tissue by polishing without intervention in the ligament but only on anatomical functional interface of cement-blasts, we can connect the positive evolution of the clinical-only component of the cement that could represent this perspective, the only reason that Periodontal Disease become a Cement Disease, while all other clinical elements as nothing more than a clinical pathological accompanying.
Abstract: Successful regional anesthesia depends upon precise location of the peripheral nerve or nerve plexus. Locating peripheral nerves is preferred to be done using nerve stimulation. In order to generate a nerve impulse by electrical means, a minimum threshold stimulus of current “rheobase” must be applied to the nerve. The technique depends on stimulating muscular twitching at a close distance to the nerve without actually touching it. Success rate of this operation depends on the accuracy of current intensity pulses used for stimulation .In this paper, we will discuss a circuit and algorithm for closed loop control for the current, theoretical analysis and test results is discussed and results is compared to previous techniques.
Abstract: This study investigates the relationship between the reliability of critical medical equipment (CME) and the effectiveness of CME maintenance management strategies in relation to patient outcomes in 84 public hospitals of a top 20 OECD country. The work has examined the effectiveness of CME maintenance management strategies used by the public hospital system of a large state run health organization. The conceptual framework was designed to examine the significance of the relationship between six variables: (1) types of maintenance management strategies, (2) maintenance services, (3) maintenance practice, (4) medical equipment reliability, (5) maintenance costs and (6) patient outcomes. The results provide interesting insights into the effectiveness of the maintenance strategies used. For example, there appears to be about a 1 in 10 000 probability of failure of anesthesia equipment, but these seem to be confined to specific maintenance situations. There are also some findings in relation to outsourcing of maintenance. For each of the variables listed, results are reported in relation to the various types of maintenance strategies and services. Decision-makers may use these results to evaluate more effective maintenance strategies for their CME and generate more effective patient outcomes.
Abstract: Determining depth of anesthesia is a challenging problem
in the context of biomedical signal processing. Various methods
have been suggested to determine a quantitative index as depth of
anesthesia, but most of these methods suffer from high sensitivity
during the surgery. A novel method based on energy scattering of
samples in the wavelet domain is suggested to represent the basic
content of electroencephalogram (EEG) signal. In this method, first
EEG signal is decomposed into different sub-bands, then samples
are squared and energy of samples sequence is constructed through
each scale and time, which is normalized and finally entropy of the
resulted sequences is suggested as a reliable index. Empirical Results
showed that applying the proposed method to the EEG signals can
classify the awake, moderate and deep anesthesia states similar to
BIS.
Abstract: Recently, there has been a considerable increase in the
number of procedures carried out under regional anesthesia.
However, percutaneous nephrolithotomy (PCNL) procedures are
usually performed under general anesthesia. The aim of this study
was to assess the safety and efficacy of PCNL under spinal anesthesia
in patients with renal calculi. We describe our 9 years experience of
performing PCNL under spinal anesthesia for 387 patients with large
stones of the upper urinary tract, with regard to the effectiveness and
side effects. All patients received spinal anesthetics (Lidocain 5%, or
Bupivacaine 0.75%) and underwent PCNL in prone position. The
success rate was 94.1%. The incidence of complications was 11.6%.
PCNL under spinal anesthesia is feasible, safe, and well-tolerated in
management of patients with renal stones.
Abstract: The linear SEF (Spectral Edge Frequency) parameter
and spectrum analysis method can not reflect the non-linear of EEG.
This method can not contribute to acquire real time analysis and obtain
a high confidence in the clinic due to low discrimination. To solve the
problems, the development of a new index is carried out using the
bispectrum analyzing the EEG(electroencephalogram) including the
non-linear characteristic. After analyzing the bispectrum of the 2
dimension, the most significant power spectrum density peaks appeared abundantly at the specific area in awakening and anesthesia state. These points are utilized to create the new index since many
peaks appeared at the specific area in the frequency coordinate. The measured range of an index was 0-100. An index is 20-50 at an anesthesia, while the index is 90-60 at the awake. New index could afford to effectively discriminate the awake and anesthesia state.
Abstract: The measurement of anesthetic depth is necessary in
anesthesiology. NN10 is very simple method among the RR intervals
analysis methods. NN10 parameter means the numbers of above the 10
ms intervals of the normal to normal RR intervals.
Bispectrum analysis is defined as 2D FFT. EEG signal reflected the
non-linear peristalsis phenomena according to the change brain
function. After analyzing the bispectrum of the 2 dimension, the most
significant power spectrum density peaks appeared abundantly at the
specific area in awakening and anesthesia state. These points are
utilized to create the new index since many peaks appeared at the
specific area in the frequency coordinate. The measured range of an
index was 0-100. An index is 20-50 at an anesthesia, while the index is
90-60 at the awake.
In this paper, the relation between NN10 parameter using ECG and
bisepctrum index using EEG is observed to estimate the depth of
anesthesia during anesthesia and then we estimated the utility of the
anesthetic.
Abstract: In this work, the surgical theater of a local hospital in
KSA was analyzed using simulation. The focus was on attempting to
answer questions related to how many Operating Rooms (ORs) to
open and to analyze the performance of the surgical theater in
general and mainly the Post Anesthesia Care Unit (PACU) to assist
making decisions regarding PACU staffing. The surgical theater
consists of ten operating rooms and the PACU unit which has a
maximum capacity of fifteen beds. Different sequencing rules to
sequence the surgical cases were tested and the Longest Case First
(LCF) were superior to others. The results of the different
alternatives developed and tested can be used by the manager as a
tool to plan and manage the OR and PACU