Abstract: We have designed a Holter that measures the heart´s activity for over 24 hours, implemented a prediction methodology, and generate alarms as well as indicators to patients and treating physicians. Various diagnostic advances have been developed in clinical cardiology thanks to Holter implementation; however, their interpretation has largely been conditioned to clinical analysis and measurements adjusted to diverse population characteristics, thus turning it into a subjective examination. This, however, requires vast population studies to be validated that, in turn, have not achieved the ultimate goal: mortality prediction. Given this context, our Insight Research Group developed a mathematical methodology that assesses cardiac dynamics through entropy and probability, creating a numerical and geometrical attractor which allows quantifying the normalcy of chronic and acute disease as well as the evolution between such states, and our Tigum Research Group developed a holter device with 12 channels and advanced computer software. This has been shown in different contexts with 100% sensitivity and specificity results.
Abstract: Introduction: This research describes the existing medical school program which supports a multicultural setting and bilingualism. The rise of Spanish speakers in the United States has led to the recruitment of bilingual medical students who can serve the evolving demographics. This paper includes anecdotal evidence, narratives and the latest research on the outcomes of supporting a multilingual academic experience in medical school and beyond. People in the United States will continue to need health care from physicians who have experience with multicultural competence. Physicians who are bilingual and possess effective communication skills will be in high demand. Methodologies: This research is descriptive. Through this descriptive research, the researcher will describe the qualities and characteristics of the existing medical school programs, curriculum, and student services. Additionally, the researcher will shed light on the existing curriculum in the medical school and also describe specific programs which help to serve as safety nets to support diverse populations. The method included observations of the existing program and the implementation of the medical school program, specifically the Accelerated Review Program, the Language Education and Professional Communication Program, student organizations and the Global Health Institute. Concluding Statement: This research identified and described characteristics of the medical school’s program. The research explained and described the current and present phenomenon of this medical program, which has focused on increasing the graduation of bilingual and minority physicians. The findings are based on observations of the curriculum, programs and student organizations which evolves and remains innovative to stay current with student enrollment.
Abstract: Ability of adaptation of the organism is considered as an important component of health in maintaining relative dynamic constancy of the hemostasis and functioning of all organs and systems. Among the various forms of adaptation (individual, species and mental), social adaptation of the organism has a particular role. The aim of this study was to evaluate the subjective perception of social factors, social welfare and the level of adaptability of Armenian physicians. The survey involved 2,167 physicians (592 men and 1,575 women). According to the survey, most physicians (75.1%) were married. It was found that 88.6% of respondents had harmonious family relationships, 7.6% of respondents – tense relationships, and 1.0% – marginal relationships. The results showed that the average monthly salary with all premium payments amounted to 88 263.6±5.0 drams, and 16.7% of physicians heavily relied on the material support of parents or other relatives. Low material welfare was also confirmed by the analysis of the living conditions. Analysis of the results showed that the degree of subjective perception of social factors of different specialties averaged 11.3±3.1 points, which corresponds to satisfactory results (a very good result – 4.0 points). The degree of social adaptation of physicians on average makes 4.13±1.9 points, which corresponds to poor results (allowable less than 3.0 points). The distribution of the results of social adaptation severity revealed that the majority of physicians (58.6%) showed low social adaptation, average social adaptation is observed in 22.4% of the physicians and high adaptation – in only 17.4% of physicians. In conclusions, the findings of this study suggest that the degree of social adaptation of currently practicing physicians is low.
Abstract: Aims and Objectives: Assessment of health status and detection disorders of external respiration functions (ERF) during preventative medical examination among physicians of Armenia. Subjects and Methods: Overall, fifty-nine physicians (17 men and 42 women) were examined and spirometry was carried out. The average age of the physicians was 50 years old. The studies were conducted on the Micromedical MicroLab 3500 Spirometer. Results: 25.4% among 59 examined physicians are overweight; 22.0% of them suffer from obesity. Two physicians are currently smokers. About half of the examined physicians (50.8%) at the time of examination were diagnosed with some diseases and had different health-related problems (excluding the problems related to vision and hearing). FVC was 2.94±0.1, FEV1 – 2.64±0.1, PEF – 329.7±19.9, and FEV1%/FVC – 89.7±1.3. Pathological changes of ERF are identified in 23 (39.0%) cases. 28.8% of physicians had first degree of restrictive disorders, 3.4% – first degree of combined obstructive/ restrictive disorders, 6.8% – second degree of combined obstructive/ restrictive disorders. Only three physicians with disorders of the ERF were diagnosed with chronic bronchitis and bronchial asthma. There were no statistically significant changes in ERF depending on the severity of obesity (P> 0.05). Conclusion: The study showed the prevalence of ERF among physicians, observing mainly mild and moderate changes in ERF parameters.
Abstract: Hepatitis is one of the most common and dangerous diseases that affects humankind, and exposes millions of people to serious health risks every year. Diagnosis of Hepatitis has always been a challenge for physicians. This paper presents an effective method for diagnosis of hepatitis based on interval Type-II fuzzy. This proposed system includes three steps: pre-processing (feature selection), Type-I and Type-II fuzzy classification, and system evaluation. KNN-FD feature selection is used as the preprocessing step in order to exclude irrelevant features and to improve classification performance and efficiency in generating the classification model. In the fuzzy classification step, an “indirect approach” is used for fuzzy system modeling by implementing the exponential compactness and separation index for determining the number of rules in the fuzzy clustering approach. Therefore, we first proposed a Type-I fuzzy system that had an accuracy of approximately 90.9%. In the proposed system, the process of diagnosis faces vagueness and uncertainty in the final decision. Thus, the imprecise knowledge was managed by using interval Type-II fuzzy logic. The results that were obtained show that interval Type-II fuzzy has the ability to diagnose hepatitis with an average accuracy of 93.94%. The classification accuracy obtained is the highest one reached thus far. The aforementioned rate of accuracy demonstrates that the Type-II fuzzy system has a better performance in comparison to Type-I and indicates a higher capability of Type-II fuzzy system for modeling uncertainty.
Abstract: Availability of different genetic tests after completion
of Human Genome Project increases the physicians’ responsibility to
keep themselves update on the potential implementation of these
genetic tests in their daily practice. However, due to numbers of
barriers, still many of physicians are not either aware of these tests or
are not willing to offer or refer their patients for genetic tests. This
study was conducted an anonymous, cross-sectional, mailed-based
survey to develop a primary data of Malaysian physicians’ level of
knowledge and perception of gene profiling. Questionnaire had 29
questions. Total scores on selected questions were used to assess the
level of knowledge. The highest possible score was 11. Descriptive
statistics, one way ANOVA and chi-squared test was used for
statistical analysis. Sixty three completed questionnaires were
returned by 27 general practitioners (GPs) and 36 medical specialists.
Responders’ age ranges from 24 to 55 years old (mean 30.2 ± 6.4).
About 40% of the participants rated themselves as having poor level
of knowledge in genetics in general whilst 60% believed that they
have fair level of knowledge; however, almost half (46%) of the
respondents felt that they were not knowledgeable about available
genetic tests. A majority (94%) of the responders were not aware of
any lab or company which is offering gene profiling services in
Malaysia. Only 4% of participants were aware of using gene profiling
for detection of dosage of some drugs. Respondents perceived greater
utility of gene profiling for breast cancer (38%) compared to the
colorectal familial cancer (3%). The score of knowledge ranged from
2 to 8 (mean 4.38 ± 1.67). Non- significant differences between score
of knowledge of GPs and specialists were observed, with score of
4.19 and 4.58 respectively. There was no significant association
between any demographic factors and level of knowledge. However,
those who graduated between years 2001 to 2005 had higher level of
knowledge. Overall, 83% of participants showed relatively high level
of perception on value of gene profiling to detect patient’s risk of
disease. However, low perception was observed for both statements
of using gene profiling for general population in order to alter their
lifestyle (25%) as well as having the full sequence of a patient
genome for the purpose of determining a patient’s best match for
treatment (18%). The lack of clinical guidelines, limited provider
knowledge and awareness, lack of time and resources to educate
patients, lack of evidence-based clinical information and cost of tests
were the most barriers of ordering gene profiling mentioned by
physicians. In conclusion Malaysian physicians who participate in
this study had mediocre level of knowledge and awareness in gene
profiling. The low exposure to the genetic questions and problems
might be a key predictor of lack of awareness and knowledge on
available genetic tests. Educational and training workshop might be useful in helping Malaysian physicians incorporate genetic profiling
into practice for eligible patients.
Abstract: In this paper, we propose an intelligent system that is
used for monitoring the health conditions of patients. Monitoring the
health condition of patients is a complex problem that involves
different medical units and requires continuous monitoring especially
in rural areas because of inadequate number of available specialized
physicians. The proposed system will improve patient care and drive
costs down comparing to the existing system in Jordan. The proposed
system will be the start point to faster and improve the
communication between different units in the health system in
Jordan. Connecting patients and their physicians beyond hospital
doors regarding their geographical area is an important issue in
developing the health system in Jordan. The ability of making
medical decisions, the quality of medical is expected to be improved.
Abstract: Background and aim: It has not been well studied
whether fentanyl-thiopental (FT) is effective and safe for PSA in
orthopedic procedures in Emergency Department (ED). The aim of
this trial was to evaluate the effectiveness of intravenous FT versus
fentanyl-midazolam (FM) in patients who suffered from shoulder
dislocation or distal radial fracture-dislocation.
Methods: In this randomized double-blinded study, Seventy-six
eligible patients were entered the study and randomly received
intravenous FT or FM. The success rate, onset of action and recovery
time, pain score, physicians’ satisfaction and adverse events were
assessed and recorded by treating emergency physicians. The
statistical analysis was intention to treat.
Results: The success rate after administrating loading dose in FT
group was significantly higher than FM group (71.7% vs. 48.9%,
p=0.04); however, the ultimate unsuccessful rate after 3 doses of
drugs in the FT group was higher than the FM group (3 to 1) but it
did not reach to significant level (p=0.61). Despite near equal onset
of action time in two study group (P=0.464), the recovery period in
patients receiving FT was markedly shorter than FM group
(P
Abstract: Medical image is an integral part of e-health care and e-diagnosis system. Medical image watermarking is widely used to protect patients’ information from malicious alteration and manipulation. The watermarked medical images are transmitted over the internet among patients, primary and referred physicians. The images are highly prone to corruption in the wireless transmission medium due to various noises, deflection, and refractions. Distortion in the received images leads to faulty watermark detection and inappropriate disease diagnosis. To address the issue, this paper utilizes error correction code (ECC) with (8, 4) Hamming code in an existing watermarking system. In addition, we implement the high complex ECC on a graphics processing units (GPU) to accelerate and support real-time requirement. Experimental results show that GPU achieves considerable speedup over the sequential CPU implementation, while maintaining 100% ECC efficiency.
Abstract: In this paper, an automatic detecting algorithm for
QRS complex detecting was applied for analyzing ECG recordings
and five criteria for dangerous arrhythmia diagnosing are applied for a
protocol type of automatic arrhythmia diagnosing system. The
automatic detecting algorithm applied in this paper detected the
distribution of QRS complexes in ECG recordings and related
information, such as heart rate and RR interval. In this investigation,
twenty sampled ECG recordings of patients with different pathologic
conditions were collected for off-line analysis. A combinative
application of four digital filters for bettering ECG signals and
promoting detecting rate for QRS complex was proposed as
pre-processing. Both of hardware filters and digital filters were
applied to eliminate different types of noises mixed with ECG
recordings. Then, an automatic detecting algorithm of QRS complex
was applied for verifying the distribution of QRS complex. Finally,
the quantitative clinic criteria for diagnosing arrhythmia were
programmed in a practical application for automatic arrhythmia
diagnosing as a post-processor. The results of diagnoses by automatic
dangerous arrhythmia diagnosing were compared with the results of
off-line diagnoses by experienced clinic physicians. The results of
comparison showed the application of automatic dangerous
arrhythmia diagnosis performed a matching rate of 95% compared
with an experienced physician-s diagnoses.
Abstract: In this paper we address the issue of classifying the fluorescent intensity of a sample in Indirect Immuno-Fluorescence (IIF). Since IIF is a subjective, semi-quantitative test in its very nature, we discuss a strategy to reliably label the image data set by using the diagnoses performed by different physicians. Then, we discuss image pre-processing, feature extraction and selection. Finally, we propose two ANN-based classifiers that can separate intrinsically dubious samples and whose error tolerance can be flexibly set. Measured performance shows error rates less than 1%, which candidates the method to be used in daily medical practice either to perform pre-selection of cases to be examined, or to act as a second reader.
Abstract: Object: Review recent publications of patient safety
culture to investigate the relationship between leadership behavior,
safety culture, and safety performance in the healthcare industry.
Method: This study is a cross-sectional study, 350 questionnaires were
mailed to hospital workers with 195 valid responses obtained, and a
55.7% valid response rate. Confirmatory factor analysis (CFA) was
carried out to test the factor structure and determine if the composite
reliability was significant with a factor loading of >0.5, resulting in an
acceptable model fit. Results: Through the analysis of One-way
ANOVA, the results showed that physicians significantly have more
negative patient safety culture perceptions and safety performance
perceptions than non- physicians. Conclusions: The path analysis
results show that leadership behavior affects safety culture and safety
performance in the health care industry. Safety performance was
affected and improved with contingency leadership and a positive
patient safety organization culture. The study suggests improving
safety performance by providing a well-managed system that
includes: consideration of leadership, hospital worker training
courses, and a solid safety reporting system.
Abstract: The application of Neural Network for disease
diagnosis has made great progress and is widely used by physicians.
An Electrocardiogram carries vital information about heart activity and physicians use this signal for cardiac disease diagnosis which
was the great motivation towards our study. In our work, tachycardia
features obtained are used for the training and testing of a Neural
Network. In this study we are using Fuzzy Probabilistic Neural
Networks as an automatic technique for ECG signal analysis. As
every real signal recorded by the equipment can have different
artifacts, we needed to do some preprocessing steps before feeding it
to our system. Wavelet transform is used for extracting the
morphological parameters of the ECG signal. The outcome of the
approach for the variety of arrhythmias shows the represented
approach is superior than prior presented algorithms with an average
accuracy of about %95 for more than 7 tachy arrhythmias.
Abstract: Prostate cancer is one of the most frequent cancers in men and is a major cause of mortality in the most of countries. In many diagnostic and treatment procedures for prostate disease accurate detection of prostate boundaries in transrectal ultrasound (TRUS) images is required. This is a challenging and difficult task due to weak prostate boundaries, speckle noise and the short range of gray levels. In this paper a novel method for automatic prostate segmentation in TRUS images is presented. This method involves preprocessing (edge preserving noise reduction and smoothing) and prostate segmentation. The speckle reduction has been achieved by using stick filter and top-hat transform has been implemented for smoothing. A feed forward neural network and local binary pattern together have been use to find a point inside prostate object. Finally the boundary of prostate is extracted by the inside point and an active contour algorithm. A numbers of experiments are conducted to validate this method and results showed that this new algorithm extracted the prostate boundary with MSE less than 4.6% relative to boundary provided manually by physicians.