Abstract: Prior to the use of detectors, characteristics
comparison study was performed and baseline established. In patient
specific QA, the portal dosimetry mean values of area gamma,
average gamma and maximum gamma were 1.02, 0.31 and 1.31 with
standard deviation of 0.33, 0.03 and 0.14 for IMRT and the
corresponding values were 1.58, 0.48 and 1.73 with standard
deviation of 0.31, 0.06 and 0.66 for VMAT. With ImatriXX 2-D
array system, on an average 99.35% of the pixels passed the criteria
of 3%-3 mm gamma with standard deviation of 0.24 for dynamic
IMRT. For VMAT, the average value was 98.16% with a standard
deviation of 0.86. The results showed that both the systems can be
used in patient specific QA measurements for IMRT and VMAT.
The values obtained with the portal dosimetry system were found to
be relatively more consistent compared to those obtained with
ImatriXX 2-D array system.
Abstract: Functional Magnetic Resonance Imaging(fMRI) is a
noninvasive imaging technique that measures the hemodynamic
response related to neural activity in the human brain. Event-related
functional magnetic resonance imaging (efMRI) is a form of
functional Magnetic Resonance Imaging (fMRI) in which a series of
fMRI images are time-locked to a stimulus presentation and averaged
together over many trials. Again an event related potential (ERP) is a
measured brain response that is directly the result of a thought or
perception. Here the neuronal response of human visual cortex in
normal healthy patients have been studied. The patients were asked
to perform a visual three choice reaction task; from the relative
response of each patient corresponding neuronal activity in visual
cortex was imaged. The average number of neurons in the adult
human primary visual cortex, in each hemisphere has been estimated
at around 140 million. Statistical analysis of this experiment was
done with SPM5(Statistical Parametric Mapping version 5) software.
The result shows a robust design of imaging the neuronal activity of
human visual cortex.
Abstract: Osteoarthritis (OA) is the most prevalent and far common debilitating form of arthritis which can be defined as a degenerative condition affecting synovial joint. Patients suffering from osteoarthritis often complain of dull ache pain on movement.
Physical agents can fight the painful process when correctly indicated and used such as heat or cold therapy Aim. This study was carried out to: Compare the effect of cold, warm and contrast therapy on controlling knee osteoarthritis associated problems. Setting: The study was carried out in orthopedic outpatient clinics of Menoufia University and teaching Hospitals, Egypt. Sample: A convenient sample of 60 adult patients with unilateral knee osteoarthritis. Tools: three tools were utilized to collect the data. Tool I : An interviewing questionnaire. It comprised of three parts covering sociodemographic data, medical data and adverse effects of the treatment protocol. Tool II : Knee Injury and Osteoarthritis Outcome Score (KOOS) It consists of five main parts. Tool II1 : 0-10 Numeric pain rating scale. Results: reveled that the total knee symptoms score was decreased from moderate symptoms pre intervention to mild symptoms after warm and contrast method of therapy, but the contrast therapy had significant effect in reducing the knee symptoms and pain than the other symptoms. Conclusions: all of the three
methods of therapy resulted in improvement in all knee symptoms and pain but the most appropriate protocol of treatment to relive symptoms and pain was contrast therapy.
Abstract: Biological, psychological and social experiences and
perceptions of healthcare services in patients medically diagnosed of
coronary heart disease were investigated using a sample of 10
participants whose responses to the in-depth interview questions
were analyzed based on inter-and-intra-case analyses. The results
obtained revealed that advancing age, single status, divorce and/or
death of spouse and the issue of single parenting negatively impacted
patients- biopsychosocial experiences. The patients- experiences of
physical signs and symptoms, anxiety and depression, past serious
medical conditions, use of self-prescribed medications, family
history of poor mental/medical or physical health, nutritional
problems and insufficient physical activities heightened their risk of
coronary attack. Collectivist culture served as a big source of relieve
to the patients. Patients- temperament, experience of different
chronic life stresses/challenges, mood alteration, regular drinking,
smoking/gambling, and family/social impairments compounded their
health situation. Patients were satisfied with the biomedical services
rendered by the healthcare personnel, whereas their psychological
and social needs were not attended to. Effective procedural treatment
model, a holistic and multidimensional approach to the treatment of
heart disease patients was proposed.
Abstract: Physiological control of a left ventricle assist device (LVAD) is generally a complicated task due to diverse operating environments and patient variability. In this work, a tracking control algorithm based on sliding mode and feed forward control for a class of discrete-time single input single output (SISO) nonlinear uncertain systems is presented. The controller was developed to track the reference trajectory to a set operating point without inducing suction in the ventricle. The controller regulates the estimated mean pulsatile flow Qp and mean pulsatility index of pump rotational speed PIω that was generated from a model of the assist device. We recall the principle of the sliding mode control theory then we combine the feed-forward control design with the sliding mode control technique to follow the reference trajectory. The uncertainty is replaced by its upper and lower boundary. The controller was tested in a computer simulation covering two scenarios (preload and ventricular contractility). The simulation results prove the effectiveness and the robustness of the proposed controller
Abstract: The main objective of our study is to collect data
about the profile of the asthmatic patients in Assam and thereby have
a comprehensive knowledge of the factors influencing the asthmatic
patients of the state and their medication pattern. We developed a
search strategy to find any publication about the community based
survey asthma related and used. These to search the MEDLINE
(1996 to current literature) CINAHL DOAJ pubmed databases using
the key phrases, Asthma, Respiratory disorders, Drug therapy of
Asthma, database decision support system and asthma. The
appropriate literature was printed out from the online source and
library (Journal) source. The study was conducted through a set of
structured and non-structured questionnaires targeted on the
asthmatic patients belonging to the rural and urban areas of Assam,
during the month of Dec 2006 to July 2007, 138 cases were studied
in Gauwathi Medical College & Hospital located in Bhangagarh,
Assam in India. The demographic characteristics a factor in 138
patients with asthma with allergic rhinitis (cases) gives the detail
profile of asthmatic patient-s distribution of Assam as classified on
the basis of age and sex. It is evident from the study that male
populations (66%) are more prone to asthma as compared to the
females (34%).Another striking features that emerged from this
survey is the maximum prevalence of asthma in the age group of 20-
30 years followed by infants belonging to the age group of 7 (0.05%)
0-10years among both male and female populations of Assam. The
high incidence of asthma in the age group of 20-30 years may
probably be due to the allergy arising out of sudden exposure to dust
and pollen which the children face while playing and going to the
school. The rural females in the age group of 30-40 years are more
prone to asthma than urban females in the same age group may be
due to sex differentiation among the tribal population of the state.
Pharmacists should educate the asthmatics how to use inhalers
considering growing menace of asthma in the state. Safer drugs
should be produced in the form of aerosol so that easy administration
by the asthmatic patients and physicians of the state is possible for
curing asthma. The health centers should be more equipped with the
medicines to cure asthma in the state like Assam.
Abstract: Bleeding in the digestive duct is an important diagnostic parameter for patients. Blood in the endoscopic image can be determined by investigating the color tone of blood due to the degree of oxygenation, under- or over- illumination, food debris and secretions, etc. However, we found that how to pre-process raw images obtained from the capsule detectors was very important. We applied various image process methods suitable for the capsule endoscopic image in order to remove noises and unbalanced sensitivities for the image pixels. The results showed that much improvement was achieved by additional pre-processing techniques on the algorithm of determining bleeding areas.
Abstract: The medical studies often require different methods
for parameters selection, as a second step of processing, after the
database-s designing and filling with information. One common
task is the selection of fields that act as risk factors using wellknown
methods, in order to find the most relevant risk factors and
to establish a possible hierarchy between them. Different methods
are available in this purpose, one of the most known being the
binary logistic regression. We will present the mathematical
principles of this method and a practical example of using it in the
analysis of the influence of 10 different psychiatric diagnostics
over 4 different types of offences (in a database made from 289
psychiatric patients involved in different types of offences).
Finally, we will make some observations about the relation
between the risk factors hierarchy established through binary
logistic regression and the individual risks, as well as the results of
Chi-squared test. We will show that the hierarchy built using the
binary logistic regression doesn-t agree with the direct order of risk
factors, even if it was naturally to assume this hypothesis as being
always true.
Abstract: Thailand-s health system is challenged by the rising
number of patients and decreasing ratio of medical
practitioners/patients, especially in rural areas. This may tempt
inexperienced GPs to rush through the process of anamnesis with the
risk of incorrect diagnosis. Patients have to travel far to the hospital
and wait for a long time presenting their case. Many patients try to
cure themselves with traditional Thai medicine. Many countries are
making use of the Internet for medical information gathering,
distribution and storage. Telemedicine applications are a relatively
new field of study in Thailand; the infrastructure of ICT had
hampered widespread use of the Internet for using medical
information. With recent improvements made health and technology
professionals can work out novel applications and systems to help
advance telemedicine for the benefit of the people. Here we explore
the use of telemedicine for people with health problems in rural areas
in Thailand and present a Telemedicine Diagnosis System for Rural
Thailand (TEDIST) for diagnosing certain conditions that people
with Internet access can use to establish contact with Community
Health Centers, e.g. by mobile phone. The system uses a Web-based
input method for individual patients- symptoms, which are taken by
an expert system for the analysis of conditions and appropriate
diseases. The analysis harnesses a knowledge base and a backward
chaining component to find out, which health professionals should be
presented with the case. Doctors have the opportunity to exchange
emails or chat with the patients they are responsible for or other
specialists. Patients- data are then stored in a Personal Health Record.
Abstract: Purpose: Planning and dosimetry of different VMAT algorithms (SmartArc, Ergo++, Autobeam) is compared with IMRT for Head and Neck Cancer patients. Modelling was performed to rule out the causes of discrepancies between planned and delivered dose. Methods: Five HNC patients previously treated with IMRT were re-planned with SmartArc (SA), Ergo++ and Autobeam. Plans were compared with each other and against IMRT and evaluated using DVHs for PTVs and OARs, delivery time, monitor units (MU) and dosimetric accuracy. Modelling of control point (CP) spacing, Leaf-end Separation and MLC/Aperture shape was performed to rule out causes of discrepancies between planned and delivered doses. Additionally estimated arc delivery times, overall plan generation times and effect of CP spacing and number of arcs on plan generation times were recorded. Results: Single arc SmartArc plans (SA4d) were generally better than IMRT and double arc plans (SA2Arcs) in terms of homogeneity and target coverage. Double arc plans seemed to have a positive role in achieving improved Conformity Index (CI) and better sparing of some Organs at Risk (OARs) compared to Step and Shoot IMRT (ss-IMRT) and SA4d. Overall Ergo++ plans achieved best CI for both PTVs. Dosimetric validation of all VMAT plans without modelling was found to be lower than ss-IMRT. Total MUs required for delivery were on average 19%, 30%, 10.6% and 6.5% lower than ss-IMRT for SA4d, SA2d (Single arc with 20 Gantry Spacing), SA2Arcs and Autobeam plans respectively. Autobeam was most efficient in terms of actual treatment delivery times whereas Ergo++ plans took longest to deliver. Conclusion: Overall SA single arc plans on average achieved best target coverage and homogeneity for both PTVs. SA2Arc plans showed improved CI and some OARs sparing. Very good dosimetric results were achieved with modelling. Ergo++ plans achieved best CI. Autobeam resulted in fastest treatment delivery times.
Abstract: The use of the oncologic index ISTER allows for a more effective planning of the radiotherapic facilities in the hospitals. Any change in the radiotherapy treatment, due to unexpected stops, may be adapted by recalculating the doses to the new treatment duration while keeping the optimal prognosis. The results obtained in a simulation model on millions of patients allow the definition of optimal success probability algorithms.
Abstract: This paper employs a new approach to regulate the
blood glucose level of type I diabetic patient under an intensive
insulin treatment. The closed-loop control scheme incorporates
expert knowledge about treatment by using reinforcement learning
theory to maintain the normoglycemic average of 80 mg/dl and the
normal condition for free plasma insulin concentration in severe
initial state. The insulin delivery rate is obtained off-line by using Qlearning
algorithm, without requiring an explicit model of the
environment dynamics. The implementation of the insulin delivery
rate, therefore, requires simple function evaluation and minimal
online computations. Controller performance is assessed in terms of
its ability to reject the effect of meal disturbance and to overcome the
variability in the glucose-insulin dynamics from patient to patient.
Computer simulations are used to evaluate the effectiveness of the
proposed technique and to show its superiority in controlling
hyperglycemia over other existing algorithms
Abstract: Today, the Internet based communication has widen
the opportunity of event monitoring system in the medical field.
There is always a need of analyzing and designing secure and reliable
mobile communication between the hospital and biomedical
engineers mobile units. This study has been carried out to find
possible solution using SIP-based event notification for alerting the
technical staff about the Biomedical Device (BMD) status and
Patients treatment session. The Session Initiation Protocol (SIP) can
be used to create a medical event notification system. SIP can work
on a variety of devices. Its adoption as the protocol of choice for third
generation wireless networks allows for a robust and scalable
environment. One of the advantages of SIP is that it supports personal
mobility through the separation of user addressing and device
addressing. The solution for Telemed alert notification system is
based on SIP - Specific Event Notification. The aim of this project is
to extend mobility service to the hospital technicians who are using
Telemedicine system.
Abstract: Most CT reconstruction system x-ray computed
tomography (CT) is a well established visualization technique in
medicine and nondestructive testing. However, since CT scanning
requires sampling of radiographic projections from different viewing
angles, common CT systems with mechanically moving parts are too
slow for dynamic imaging, for instance of multiphase flows or live
animals. A large number of X-ray projections are needed to
reconstruct CT images, so the collection and calculation of the
projection data consume too much time and harmful for patient. For
the purpose of solving the problem, in this study, we proposed a
method for tomographic reconstruction of a sample from a limited
number of x-ray projections by using linear interpolation method. In
simulation, we presented reconstruction from an experimental x-ray
CT scan of a Aluminum phantom that follows to two steps: X-ray
projections will be interpolated using linear interpolation method and
using it for CT reconstruction based upon Ordered Subsets
Expectation Maximization (OSEM) method.
Abstract: A method and apparatus for noninvasive measurement
of blood glucose concentration based on transilluminated laser beam
via the Index Finger has been reported in this paper. This method
depends on atomic gas (He-Ne) laser operating at 632.8nm
wavelength. During measurement, the index finger is inserted into the
glucose sensing unit, the transilluminated optical signal is converted
into an electrical signal, compared with the reference electrical
signal, and the obtained difference signal is processed by signal
processing unit which presents the results in the form of blood
glucose concentration. This method would enable the monitoring
blood glucose level of the diabetic patient continuously, safely and
noninvasively.
Abstract: Diagnosis can be achieved by building a model of a
certain organ under surveillance and comparing it with the real time
physiological measurements taken from the patient. This paper deals
with the presentation of the benefits of using Data Mining techniques
in the computer-aided diagnosis (CAD), focusing on the cancer
detection, in order to help doctors to make optimal decisions quickly
and accurately. In the field of the noninvasive diagnosis techniques,
the endoscopic ultrasound elastography (EUSE) is a recent elasticity
imaging technique, allowing characterizing the difference between
malignant and benign tumors. Digitalizing and summarizing the main
EUSE sample movies features in a vector form concern with the use
of the exploratory data analysis (EDA). Neural networks are then
trained on the corresponding EUSE sample movies vector input in
such a way that these intelligent systems are able to offer a very
precise and objective diagnosis, discriminating between benign and
malignant tumors. A concrete application of these Data Mining
techniques illustrates the suitability and the reliability of this
methodology in CAD.
Abstract: Due to the emergence of “Humanized Healthcare"
introduced by Professor Dr. Prawase Wasi in 2003[1], the
development of this paradigm tends to be widely implemented. The
organizations included Healthcare Accreditation Institute (public
organization), National Health Foundation, Mahidol University in
cooperation with Thai Health Promotion Foundation, and National
Health Security Office (Thailand) have selected the hospitals or
infirmaries that are qualified for humanized healthcare since 2008-
2010 and 35 of them are chosen to be the outstandingly navigating
organizations for the development of humanized healthcare,
humanized healthcare award [2].
The research aims to study the current issue, characteristics and
patterns of hospital administration contributing to humanized
healthcare system in Thailand. The selected case studies are from
four hospitals including Dansai Crown Prince Hospital, Leoi;
Ubolrattana Hospital, Khon Kaen; Kapho Hospital, Pattani; and
Prathai Hospital, Nakhonrachasima. The methodology is in-depth
interviewing with 10 staffs working as hospital executive directors,
and representatives from leader groups including directors,
multidisciplinary hospital committees, personnel development
committees, physicians and nurses in each hospital. (Total=40) In
addition, focus group discussions between hospital staffs and general
people (including patients and their relatives, the community leader,
and other people) are held by means of setting 4 groups including 8
people within each group. (Total=128) The observation on the
working in each hospital is also implemented. The findings of the
study reveal that there are five important aspects found in each
hospital including (1) the quality improvement under the mental and
spiritual development policy from the chief executives and lead
teams, leaders as Role model and they have visionary leadership; (2)
the participation hospital administration system focusing on learning
process and stakeholder- needs, spiritual human resource
management and development; (3) the relationship among people
especially staffs, team work skills, mutual understanding, effective
communication and personal inner-development; (4) organization
culture relevant to the awareness of patients- rights as well as the
participation policy including spiritual growth achieving to the same
goals, sharing vision, developing public mind, and caring; and (5)
healing structures or environment providing warmth and convenience
for hospital staffs, patients and their relatives and visitors.
Abstract: This paper presents a new spread-spectrum
watermarking algorithm for digital images in discrete wavelet
transform (DWT) domain. The algorithm is applied for embedding
watermarks like patient identification /source identification or
doctors signature in binary image format into host digital
radiological image for potential telemedicine applications.
Performance of the algorithm is analysed by varying the gain factor,
subband decomposition levels, and size of watermark. Simulation
results show that the proposed method achieves higher watermarking
capacity.
Abstract: Hepatocellular carcinoma, also called hepatoma, most
commonly appears in a patient with chronic viral hepatitis. In
patients with a higher suspicion of HCC, such as small or subtle
rising of serum enzymes levels, the best method of diagnosis
involves a CT scan of the abdomen, but only at high cost. The aim of
this study was to increase the ability of the physician to early detect
HCC, using a probabilistic neural network-based approach, in order
to save time and hospital resources.
Abstract: Oral health is particular important to the hospitalized
patients with chronic schizophrenia for an extreme high potential of the respiratory infections. Due to the degeneration of physical capability, patients of this kind typically fall dependent in the activity of daily living (ADL). A very high percentage of patients had dental
problems of which mostly could be easily avoid by easy regular tooth brushing. Purpose of the project is to develop a mechanism in helping the schizophrenia patients in rebuilding a tooth-cleaning habit. The
project observed and evaluated the tooth-cleaning behavior of 100
male patients in a psychiatric hospital, and found the majority of them
ignored such an activity in a three-month period of time. In the meantime, the primary care-givers were not aware or not convinced
the importance of such a need of dental hygiene, and thus few if any
tooth cleaning training or knowledge on dental hygiene were given to
the patients. The project then developed a program based on the numerous observations and discussions. The improvement program
included patients- group education, care-givers- training, and a
tool-kit for tooth-brush holding was erected. The project launched
with some incentive package. The outcomes were encouraging with
87% of the patients had rebuilt their tooth-brushing habits against
previous 22%, and the tooth cleaning kits were 100% kept against 22%
in the past. This project had significantly improved the oral health of
the patients. The project, included the procedure and the tool-kit
holder specific for this purpose, was a good examples for psychiatric
hospitals.