Abstract: Deaths from cardiovascular diseases have decreased substantially over the past two decades, largely as a result of advances in acute care and cardiac surgery. These developments have produced a growing population of patients who have survived a myocardial infarction. These patients need to be continuously monitored so that the initiation of treatment can be given within the crucial golden hour. The available conventional methods of monitoring mostly perform offline analysis and restrict the mobility of these patients within a hospital or room. Hence the aim of this paper is to design a Portable Cardiac Telemedicine System to aid the patients to regain their independence and return to an active work schedule, there by improving the psychological well being. The portable telemedicine system consists of a Wearable ECG Transmitter (WET) and a slightly modified mobile phone, which has an inbuilt ECG analyzer. The WET is placed on the body of the patient that continuously acquires the ECG signals from the high-risk cardiac patients who can move around anywhere. This WET transmits the ECG to the patient-s Bluetooth enabled mobile phone using blue tooth technology. The ECG analyzer inbuilt in the mobile phone continuously analyzes the heartbeats derived from the received ECG signals. In case of any panic condition, the mobile phone alerts the patients care taker by an SMS and initiates the transmission of a sample ECG signal to the doctor, via the mobile network.
Abstract: In this paper, we present user pattern learning
algorithm based MDSS (Medical Decision support system) under
ubiquitous. Most of researches are focus on hardware system, hospital
management and whole concept of ubiquitous environment even
though it is hard to implement. Our objective of this paper is to design
a MDSS framework. It helps to patient for medical treatment and
prevention of the high risk patient (COPD, heart disease, Diabetes).
This framework consist database, CAD (Computer Aided diagnosis
support system) and CAP (computer aided user vital sign prediction
system). It can be applied to develop user pattern learning algorithm
based MDSS for homecare and silver town service. Especially this
CAD has wise decision making competency. It compares current vital
sign with user-s normal condition pattern data. In addition, the CAP
computes user vital sign prediction using past data of the patient. The
novel approach is using neural network method, wireless vital sign
acquisition devices and personal computer DB system. An intelligent
agent based MDSS will help elder people and high risk patients to
prevent sudden death and disease, the physician to get the online
access to patients- data, the plan of medication service priority (e.g.
emergency case).
Abstract: Chronic conditions carry with them strong emotions
and often lead to charged relationships between patients and their
health providers and, by extension, patients and health researchers.
Persons are both autonomous and relational and a purely cognitive
model of autonomy neglects the social and relational basis of chronic
illness. Ensuring genuine informed consent in research requires a
thorough understanding of how participants perceive a study and
their reasons for participation. Surveys may not capture the
complexities of reasoning that underlies study participation.
Contradictory reasons for participation, for instance an initial claim
of altruism as rationale and a subsequent claim of personal benefit
(therapeutic misconception), affect the quality of informed consent.
Individuals apply principles through the filter of personal values and
lived experience. Authentic autonomy, and hence authentic consent
to research, occurs within the context of patients- unique life
narratives and illness experiences.
Abstract: The trends of design and development of information systems have undergone a variety of ongoing phases and stages. These variations have been evolved due to brisk changes in user requirements and business needs. To meet these requirements and needs, a flexible and agile business solution was required to come up with the latest business trends and styles. Another obstacle in agility of information systems was typically different treatment of same diseases of two patients: business processes and information services. After the emergence of information technology, the business processes and information systems have become counterparts. But these two business halves have been treated under totally different standards. There is need to streamline the boundaries of these both pillars that are equally sharing information system's burdens and liabilities. In last decade, the object orientation has evolved into one of the major solutions for modern business needs and now, SOA is the solution to shift business on ranks of electronic platform. BPM is another modern business solution that assists to regularize optimization of business processes. This paper discusses how object orientation can be conformed to incorporate or embed SOA in BPM for improved information systems.
Abstract: Y chromosome microdeletions are the most common
genetic cause of male infertility and screening for these
microdeletions in azoospermic or severely oligospermic men is now
standard practice. Analysis of the Y chromosome in men with
azoospermia or severe oligozoospermia has resulted in the
identification of three regions in the euchromatic part of the long arm
of the human Y chromosome (Yq11) that are frequently deleted in
men with otherwise unexplained spermatogenic failure. PCR analysis
of microdeletions in the AZFa, AZFb and AZFc regions of the
human Y chromosome is an important screening tool. The aim of this
study was to analyse the type of microdeletions in men with fertility
disorders in Slovakia. We evaluated 227 patients with azoospermia
and with normal karyotype. All patient samples were analyzed
cytogenetically. For PCR amplification of sequence-tagged sites
(STS) of the AZFa, AZFb and AZFc regions of the Y chromosome
was used Devyser AZF set. Fluorescently labeled primers for all
markers in one multiplex PCR reaction were used and for automated
visualization and identification of the STS markers we used genetic
analyzer ABi 3500xl (Life Technologies). We reported 13 cases of
deletions in the AZF region 5,73%. Particular types of deletions were
recorded in each region AZFa,b,c .The presence of microdeletions in
the AZFc region was the most frequent. The study confirmed that
percentage of microdeletions in the AZF region is low in Slovak
azoospermic patients, but important from a prognostic view.
Abstract: In this paper, an overview is made on the educational and research activities in the field of physical medicine and rehabilitation in Libya, including development in rehabilitation science, research, training, occupational therapy, physiotherapy and physiatrist, which are mainly concerned with the patients in Libya[3] [13].
Abstract: Wireless capsule Endoscopy (WCE) has rapidly
shown its wide applications in medical domain last ten years
thanks to its noninvasiveness for patients and support for thorough
inspection through a patient-s entire digestive system including
small intestine. However, one of the main barriers to efficient
clinical inspection procedure is that it requires large amount of
effort for clinicians to inspect huge data collected during the
examination, i.e., over 55,000 frames in video. In this paper, we
propose a method to compute meaningful motion changes of
WCE by analyzing the obtained video frames based on regional
optical flow estimations. The computed motion vectors are used to
remove duplicate video frames caused by WCE-s imaging nature,
such as repetitive forward-backward motions from peristaltic
movements. The motion vectors are derived by calculating
directional component vectors in four local regions. Our
experiments are performed on small intestine area, which is of
main interest to clinical experts when using WCEs, and our
experimental results show significant frame reductions comparing
with a simple frame-to-frame similarity-based image reduction
method.
Abstract: Human immunodeficiency virus infection and
acquired immunodeficiency syndrome is a global pandemic with
cases reporting from virtually every country and continues to be a
common infection in developing country like India.
Microalbuminuria is a manifestation of human immunodeficiency
virus associated nephropathy. Therefore, microalbuminuria may be
an early marker of human immunodeficiency virus associated
nephropathy, and screening for its presence may be beneficial. A
strikingly high prevalence of microalbuminuria among human
immunodeficiency virus infected patients has been described in
various studies. Risk factors for clinically significant proteinuria
include African - American race, higher human immunodeficiency
virus ribonucleic acid level and lower CD4 lymphocyte count. The
cardiovascular risk factors of increased systolic blood pressure and
increase fasting blood sugar level are strongly associated with
microalbuminuria in human immunodeficiency virus patient. These
results suggest that microalbuminuria may be a sign of current
endothelial dysfunction and micro-vascular disease and there is
substantial risk of future cardiovascular disease events. Positive
contributing factors include early kidney disease such as human
immunodeficiency virus associated nephropathy, a marker of end
organ damage related to co morbidities of diabetes or hypertension,
or more diffuse endothelial cells dysfunction. Nevertheless after
adjustment for non human immunodeficiency virus factors, human
immunodeficiency virus itself is a major risk factor. The presence of
human immunodeficiency virus infection is independent risk to
develop microalbuminuria in human immunodeficiency virus patient.
Cardiovascular risk factors appeared to be stronger predictors of
microalbuminuria than markers of human immunodeficiency virus
severity person with human immunodeficiency virus infection and
microalbuminuria therefore appear to potentially bear the burden of
two separate damage related to known vascular end organ damage
related to know vascular risk factors, and human immunodeficiency
virus specific processes such as the direct viral infection of kidney
cells.The higher prevalence of microalbuminuria among the human
immunodeficiency virus infected could be harbinger of future
increased risks of both kidney and cardiovascular disease. Further
study defining the prognostic significance of microalbuminuria
among human immunodeficiency virus infected persons will be
essential. Microalbuminuria seems to be a predictor of cardiovascular
disease in diabetic and non diabetic subjects, hence it can also be
used for early detection of micro vascular disease in human
immunodeficiency virus positive patients, thus can help to diagnose
the disease at the earliest.
Abstract: To understand complex living system an effort has
made by mechanical engineers and dentists to deliver prompt
products and services to patients concerned about their aesthetic look.
Since two decades various bracket systems have designed involving
techniques like milling, injection molding which are technically not
flexible for the customized dental product development. The aim of
this paper to design, develop a customized system which is
economical and mainly emphasizes the expertise design and
integration of engineering and dental fields. A custom made selfadjustable
lingual bracket and customized implants are designed and
developed using computer aided design (CAD) and rapid prototyping
technology (RPT) to improve the smiles and to overcome the
difficulties associated with conventional ones. Lengthy orthodontic
treatment usually not accepted by the patients because the patient
compliance is lost. Patient-s compliance can be improved by
facilitating faster tooth movements by designing a localized dental
vibrator using advanced engineering principles.
Abstract: Many studies have focused on the nonlinear analysis
of electroencephalography (EEG) mainly for the characterization of
epileptic brain states. It is assumed that at least two states of the
epileptic brain are possible: the interictal state characterized by a
normal apparently random, steady-state EEG ongoing activity; and
the ictal state that is characterized by paroxysmal occurrence of
synchronous oscillations and is generally called in neurology, a
seizure.
The spatial and temporal dynamics of the epileptogenic process is
still not clear completely especially the most challenging aspects of
epileptology which is the anticipation of the seizure. Despite all the
efforts we still don-t know how and when and why the seizure
occurs. However actual studies bring strong evidence that the
interictal-ictal state transition is not an abrupt phenomena. Findings
also indicate that it is possible to detect a preseizure phase.
Our approach is to use the neural network tool to detect interictal
states and to predict from those states the upcoming seizure ( ictal
state). Analysis of the EEG signal based on neural networks is used
for the classification of EEG as either seizure or non-seizure. By
applying prediction methods it will be possible to predict the
upcoming seizure from non-seizure EEG.
We will study the patients admitted to the epilepsy monitoring
unit for the purpose of recording their seizures. Preictal, ictal, and
post ictal EEG recordings are available on such patients for analysis
The system will be induced by taking a body of samples then
validate it using another. Distinct from the two first ones a third body
of samples is taken to test the network for the achievement of
optimum prediction. Several methods will be tried 'Backpropagation
ANN' and 'RBF'.
Abstract: Segmentation is an important step in medical image
analysis and classification for radiological evaluation or computer
aided diagnosis. This paper presents the problem of inaccurate lung
segmentation as observed in algorithms presented by researchers
working in the area of medical image analysis. The different lung
segmentation techniques have been tested using the dataset of 19
patients consisting of a total of 917 images. We obtained datasets of
11 patients from Ackron University, USA and of 8 patients from
AGA Khan Medical University, Pakistan. After testing the algorithms
against datasets, the deficiencies of each algorithm have been
highlighted.
Abstract: Abstract–The objectives of the current study are to determine the
prevalence, etiological agents, drug susceptibility pattern and plasmid
profile of Acinetobacter baumannii isolates from Hospital-Acquired
Infections (HAI) at Community Hospital, Al Jouf Province, Saudi
Arabia. A total of 1890 patients had developed infection during
hospital admission and were included in the study. Among those who
developed nosocomial infections, 15(9.4), 10(2.7) and 118 (12.7) had
respiratory tract infection (RTI), blood stream infections (BSI) and
urinary tract (UTI) respectively. A total of 268 bacterial isolates were
isolated from nosocomial infection. S. aureus was reported in 23.5%
for of the total isolates followed by Klebsiella pneumoniae (17.5%), E.
coli (17.2%), P. aeruginosa (11.9%), coagulase negative
staphylococcus (9%), A. baumannii (7.1%), Enterobacter spp.
(3.4%), Citrobacter freundii (3%), Proteus mirabilis (2.6%), and
Proteus vulgaris and Enterococcous faecalis (0.7%). Isolated
organisms are multi-drug resistant, predominantly Gram-positive
pathogens with a high incidence of methicillin-resistant S. aureus,
extended spectrum beta lactamase and vancomycin resistant
enterococci organisms. The RFLP (Fragment Length Polymorphisms)
patterns of plasmid preparations from isolated A. baumannii isolates
had altered RFLP patterns, possibly due to the presence of plasmid(s).
Five A. baumannii isolates harbored plasmids all of which were not
less than 2.71kbp in molecular weight. Hence, it showed that the gene
coding for the isolates were located on the plasmid DNA while the
remaining isolates which have no plasmid might showed gene coding
for antibiotic resistance being located on chromosomal DNA.
Nosocomial infections represent a current problem in Community
Hospital, Al Jouf Province, Saudi Arabia. Problems associated with
SSI include infection with multidrug resistant pathogens which are
difficult to treat and are associated with increased mortality.
Abstract: A new approach based on the consideration that electroencephalogram (EEG) signals are chaotic signals was presented for automated diagnosis of electroencephalographic changes. This consideration was tested successfully using the nonlinear dynamics tools, like the computation of Lyapunov exponents. This paper presented the usage of statistics over the set of the Lyapunov exponents in order to reduce the dimensionality of the extracted feature vectors. Since classification is more accurate when the pattern is simplified through representation by important features, feature extraction and selection play an important role in classifying systems such as neural networks. Multilayer perceptron neural network (MLPNN) architectures were formulated and used as basis for detection of electroencephalographic changes. Three types of EEG signals (EEG signals recorded from healthy volunteers with eyes open, epilepsy patients in the epileptogenic zone during a seizure-free interval, and epilepsy patients during epileptic seizures) were classified. The selected Lyapunov exponents of the EEG signals were used as inputs of the MLPNN trained with Levenberg- Marquardt algorithm. The classification results confirmed that the proposed MLPNN has potential in detecting the electroencephalographic changes.
Abstract: Our Medicine-oriented research is based on a medical
data set of real patients. It is a security problem to share
patient private data with peoples other than clinician or hospital
staff. We have to remove person identification information
from medical data. The medical data without private data
are available after a de-identification process for any research
purposes. In this paper, we introduce an universal automatic
rule-based de-identification application to do all this stuff on an
heterogeneous medical data. A patient private identification is
replaced by an unique identification number, even in burnedin
annotation in pixel data. The identical identification is used
for all patient medical data, so it keeps relationships in a data.
Hospital can take an advantage of a research feedback based
on results.
Abstract: The Electronic Health Record (EHR) system is very
general and we should pay more attention to a patient-s privacy. The
patient-s consent is one of the elements when dealing with privacy
topics. This study focuses on the creating and managing of patient
consent. The integration of the HL7 standards and the IHE BPPC
profile provides a base for the creation of patient consent. Establishing
the platform offers the patients a way to create, revoke or update their
consents. Through this platform, they can manage their consents in an
easier manner.
Abstract: The myocardial sintigraphy is an imaging modality which provides functional informations. Whereas, coronarography modality gives useful informations about coronary arteries anatomy. In case of coronary artery disease (CAD), the coronarography can not determine precisely which moderate lesions (artery reduction between 50% and 70%), known as the “gray zone", are haemodynamicaly significant. In this paper, we aim to define the relationship between the location and the degree of the stenosis in coronary arteries and the observed perfusion on the myocardial scintigraphy. This allows us to model the impact evolution of these stenoses in order to justify a coronarography or to avoid it for patients suspected being in the gray zone. Our approach is decomposed in two steps. The first step consists in modelling a coronary artery bed and stenoses of different location and degree. The second step consists in modelling the left ventricle at stress and at rest using the sphercical harmonics model and myocardial scintigraphic data. We use the spherical harmonics descriptors to analyse left ventricle model deformation between stress and rest which permits us to conclude if ever an ischemia exists and to quantify it.
Abstract: The institutions seek to improve their performance
and quality of service, so that their patients are satisfied. This
research project aims, conduct a time study program in the area of
gynecological surgery, to determine the current level of capacity and
optimize the programming time in order to adequately respond to
demand. The system is analyzed by waiting lines and uses the
simulation using ARENA to evaluate proposals for improvement and
optimization programming time each of the surgeries.
Abstract: According to the governmental data, the cases of oral
cancers doubled in the past 10 years. This had brought heavy burden to
the patients- family, the society, and the country. The literature
generally evidenced the betel nut contained particular chemicals that
can cause oral cancers. Research in Taiwan had also proofed that 90
percent of oral cancer patients had experience of betel nut chewing. It
is thus important to educate the betel-nut hobbyists to cease such a
hazardous behavior. A program was then organized to establish
several training classes across different areas specific to help ceasing
this particular habit. Purpose of this research was to explore the
attitude and intention toward ceasing betel-nut chewing before and
after attending the training classes. 50 samples were taken from a
ceasing class with average age at 45 years old with high school
education (54%). 74% of the respondents were male in service or
agricultural industries. Experiences in betel-nut chewing were 5-20
years with a dose of 1-20 pieces per day. The data had shown that 60%
of the respondents had cigarette smoking habit, and 30% of the
respondents were concurrently alcoholic dependent. Research results
indicated that the attitude, intentions, and the knowledge on oral
cancers were found significant different between before and after
attendance. This provided evidence for the effectiveness of the training
class. However, we do not perform follow-up after the class.
Noteworthy is the test result also shown that participants who were
drivers as occupation, or habitual smokers or alcoholic dependents
would be less willing to quit the betel-nut chewing. The test results
indicated as well that the educational levels and the type of occupation
may have significant impacts on an individual-s decisions in taking
betel-nut or substance abuse.
Abstract: One of the essential requirements of a realistic
surgical simulator is to reproduce haptic sensations due to the
interactions in the virtual environment. However, the interaction need
to be performed in real-time, since a delay between the user action
and the system reaction reduces the immersion sensation. In this
paper, a prototype of a coronary stent implant simulator is present;
this system allows real-time interactions with an artery by means of a
specific haptic device. To improve the realism of the simulation, the
building of the virtual environment is based on real patients- images
and a Web Portal is used to search in the geographically remote
medical centres a virtual environment with specific features in terms
of pathology or anatomy. The functional architecture of the system
defines several Medical Centres in which virtual environments built
from the real patients- images and related metadata with specific
features in terms of pathology or anatomy are stored. The searched
data are downloaded from the Medical Centre to the Training Centre
provided with a specific haptic device and with the software
necessary both to manage the interaction in the virtual environment.
After the integration of the virtual environment in the simulation
system it is possible to perform training on the specific surgical
procedure.
Abstract: The study deals with the modelling of the gas flow during heliox therapy. A special model has been developed to study the effect of the helium upon the gas flow in the airways during the spontaneous breathing. Lower density of helium compared with air decreases the Reynolds number and it allows improving the flow during the spontaneous breathing. In the cases, where the flow becomes turbulent while the patient inspires air the flow is still laminar when the patient inspires heliox. The use of heliox decreases the work of breathing and improves ventilation. It allows in some cases to prevent the intubation of the patients.