Abstract: Air bubbles have been detected in human circulation
of end-stage renal disease patients who are treated by hemodialysis.
The consequence of air embolism, air bubbles, is under recognized
and usually overlooked in daily practice. This paper shows results of
a capacitor based detection method that capable of detecting the
presence of air bubbles in the blood stream in different frequencies.
The method is based on a parallel plates capacitor made of platinum
with an area of 1.5 cm2 and a distance between the two plates is 1cm.
The dielectric material used in this capacitor is Dextran70 solution
which mimics blood rheology. Simulations were carried out using
RC circuit at two frequencies 30Hz and 3 kHz and results compared
with experiments and theory. It is observed that by injecting air
bubbles of different diameters into the device, there were significant
changes in the capacitance of the capacitor. Furthermore, it is
observed that the output voltage from the circuit increased with
increasing air bubble diameter. These results demonstrate the
feasibility of this approach in improving air bubble detection in
Hemodialysis.
Abstract: Sensory nerves in the foot play an important part in the diagnosis of various neuropathydisorders, especially in diabetes mellitus.However, a detailed description of the anatomical distribution of the nerves is currently lacking. A computationalmodel of the afferent nerves inthe foot may bea useful tool for the study of diabetic neuropathy. In this study, we present the development of an anatomically-based model of various major sensory nerves of the sole and dorsal sidesof the foot. In addition, we presentan algorithm for generating synthetic somatosensory nerve networks in the big-toe region of a right foot model. The algorithm was based on a modified version of the Monte Carlo algorithm, with the capability of being able to vary the intra-epidermal nerve fiber density in differentregionsof the foot model. Preliminary results from the combinedmodel show the realistic anatomical structure of the major nerves as well as the smaller somatosensory nerves of the foot. The model may now be developed to investigate the functional outcomes of structural neuropathyindiabetic patients.
Abstract: Segmentation is an important step in medical image
analysis and classification for radiological evaluation or computer
aided diagnosis. The CAD (Computer Aided Diagnosis ) of lung CT
generally first segment the area of interest (lung) and then analyze
the separately obtained area for nodule detection in order to
diagnosis the disease. For normal lung, segmentation can be
performed by making use of excellent contrast between air and
surrounding tissues. However this approach fails when lung is
affected by high density pathology. Dense pathologies are present in
approximately a fifth of clinical scans, and for computer analysis
such as detection and quantification of abnormal areas it is vital that
the entire and perfectly lung part of the image is provided and no
part, as present in the original image be eradicated. In this paper we
have proposed a lung segmentation technique which accurately
segment the lung parenchyma from lung CT Scan images. The
algorithm was tested against the 25 datasets of different patients
received from Ackron Univeristy, USA and AGA Khan Medical
University, Karachi, Pakistan.
Abstract: Most, if not all, public hospitals in Thailand have encountered a common problem regarding the increasing demand for medical services. The increasing number of patients causes so much strain on the hospital-s services, over-crowded, overloaded working hours, staff fatigue, medical error and long waiting time. This research studied the characteristics of operational processes of the medical care services at the medicine department in a large public university hospital. The research focuses on details regarding methods, procedures, processes, resources, and time management in overall processes. The simulation model is used as a tool to analyze the impact of various improvement strategies.
Abstract: Dengue virus is transmitted from person to person
through the biting of infected Aedes Aegypti mosquitoes. DEN-1,
DEN-2, DEN-3 and DEN-4 are four serotypes of this virus. Infection
with one of these four serotypes apparently produces permanent
immunity to it, but only temporary cross immunity to the others. The
length of time during incubation of dengue virus in human and
mosquito are considered in this study. The dengue patients are
classified into infected and infectious classes. The infectious human
can transmit dengue virus to susceptible mosquitoes but infected
human can not. The transmission model of this disease is formulated.
The human population is divided into susceptible, infected, infectious
and recovered classes. The mosquito population is separated into
susceptible, infected and infectious classes. Only infectious
mosquitoes can transmit dengue virus to the susceptible human. We
analyze this model by using dynamical analysis method. The
threshold condition is discussed to reduce the outbreak of this
disease.
Abstract: It is necessary to incorporate technological advances
achieved in the field of engineering into dentistry in order to enhance
the process of diagnosis, treatment planning and enable the doctors to
render better treatment to their patients. To achieve this ultimate goal
long distance collaborations are often necessary. This paper discusses
the various collaborative tools and their applications to solve a few
burning problems confronted by the dentists. Customization is often
the solution to most of the problems. But rapid designing,
development and cost effective manufacturing is a difficult task to
achieve. This problem can be solved using the technique of digital
manufacturing. Cases from 6 major branches of dentistry have been
discussed and possible solutions with the help of state of art
technology using rapid digital manufacturing have been proposed in
the present paper. The paper also entails the usage of existing tools in
collaborative and digital manufacturing area.
Abstract: Diabetes is one of the high prevalence diseases
worldwide with increased number of complications, with retinopathy
as one of the most common one. This paper describes how data
mining and case-based reasoning were integrated to predict
retinopathy prevalence among diabetes patients in Malaysia. The
knowledge base required was built after literature reviews and
interviews with medical experts. A total of 140 diabetes patients- data
were used to train the prediction system. A voting mechanism selects
the best prediction results from the two techniques used. It has been
successfully proven that both data mining and case-based reasoning
can be used for retinopathy prediction with an improved accuracy of
85%.
Abstract: Training with Functional Electrical Stimulation (FES)
has both physiological and psychological benefits for spinal cord
injured subjects. Commonly used methods for quantification of
spasticity have shown controversial reliability. In this study we
propose a method for quick determination of spasticity in spinal cord
injured subjects on a cycling and measurement system. 23 patients
did training sessions on an instrumented mobile FES cycle three
times a week over two months as part of their clinical rehabilitation
program. Spasticity (MAS) and the legs resistance to the pedaling
motion were assessed before and after the FES training and
measurements were done on the subjects ability to pedal with our
without motor assistance. Measurements with test persons with
incomplete spastic paraplegia have shown that spasticity is decreased
after a 30 min cycling training with functional electrical stimulation
(FES).
Abstract: Pepper spray use has gained momentum since 1992
and although the active ingredient is readily available, it is considered
a weapon with restricted use in many regions, including The
Bahamas. In light of controversy in the literature regarding the
severity of presenting respiration complaints among individuals postacute
exposure of pepper spray inhalation, this descriptive case series
study was conducted to assess the respiratory status of persons
evaluated during a mass casualty in The Bahamas. Parameters noted
were patients- demographics and respiration severity determined via
clinical examination findings, disposition and follow-up review of the
20 persons. Their most common complaint was difficulty breathing
post exposure. Two required admission and stayed for
Abstract: Automatic tube current modulation (ATCM) systems are available for all CT manufacturers and are used for the majority of patients. Understanding how the systems work and their influence on patient dose and image quality is important for CT users, in order to gain the most effective use of the systems. In the present study, a new phantom was used for evaluating dose distribution and image quality under the ATCM operation for the Toshiba Aquilion 64 CT scanner using different ATCM options and a fixed mAs technique. A routine chest, abdomen and pelvis (CAP) protocol was selected for study and Gafchromic film was used to measure entrance surface dose (ESD), peripheral dose and central axis dose in the phantom. The results show the dose reductions achievable with various ATCM options, in relation with the target noise. The doses and image noise distribution were more uniform when the ATCM system was implemented compared with the fixed mAs technique. The lower limit set for the tube current will affect the modulations especially for the lower dose option. This limit prevented the tube current being reduced further and therefore the lower dose ATCM setting resembled a fixed mAs technique. Selection of a lower tube current limit is likely to reduce doses for smaller patients in scans of chest and neck regions.
Abstract: Bone growth factors, such as Bone Morphogenic
Protein-2 (BMP-2) have been approved by the FDA to replace grafting for some surgical interventions, but the high dose requirement limits its use in patients. Noggin, an extracellular protein, blocks the effect of BMP-2 by binding to BMP. Preventing
the BMP-2/noggin interaction will help increase the free
concentration of BMP-2 and therefore should enhance its efficacy to
induce bone formation. The work presented here involves
computational design of novel small molecule inhibitory agents of BMP-2/noggin interaction, based on our current understanding of
BMP-2, and its known putative ligands (receptors and antagonists). A
successful acquisition of such an inhibitory agent of BMP-2/noggin interaction would allow clinicians to reduce the dose required of
BMP-2 protein in clinical applications to promote osteogenesis. The
available crystal structures of the BMPs, its receptors, and the binding partner noggin were analyzed to identify the critical residues
involved in their interaction. In presenting this study, LUDI de novo design method was utilized to perform virtual screening of a large
number of compounds from a commercially available library against the binding sites of noggin to identify the lead chemical compounds
that could potentially block BMP-noggin interaction with a high specificity.
Abstract: The Zung self-depression scale and Beck Anxiety Inventory were used to study the depression and anxiety levels of Armenian Crohn's disease patients, as well as to reveal the relation between emotional status and placebo effect of these patients. Despite of registered high levels of depression and anxiety, the high placebo rate during investigations was described. The importance of use of psychotherapies for optimal outcomes during treatments of Crohn's disease is obvious.
Abstract: Stevia rebaudiana Bertoni (natural sweetener) belongs
to Asteraceae family and can be used as substitute of artificial
sweeteners for diabetic patients. Conventionally, it is cultivated by
seeds or stem cutting, but seed viability rate is poor. A protocol for
callus induction and multiplication was developed to produce large
no. of calli in short period. Surface sterilized nodal, leaf and root
explants were cultured on Murashige and Skoog (MS) medium with
different concentrations of plant hormone like, IBA, kinetin, NAA,
2,4-D, and NAA in combination with 2,4-D. 100% callusing was
observed from leaf explants cultured on combination of NAA and
2,4-D after three weeks while with 2,4-D, only 10% callusing was
observed. Calli obtained from leaf and root explants were shiny green
while with nodal explants it was hard and brown. The present
findings deal with induction of callusing in Stevia to achieve the
rapid callus multiplication for study of steviol glycosides in callus
culture.
Abstract: Thrombosis can be life threatening, necessitating therefore its instant treatment. Hydergine, a nootropic agent is used as a cognition enhancer in stroke patients but relatively little is known about its anti-thrombolytic effect. To investigate this aspect, in vivo and ex vivo experiments were designed and conducted. Three groups of rats were injected 1.5mg, 3.0mg and 4.5mg hydergine intraperitonealy with and without prior exposure to fresh plasma. Positive and negative controls were run in parallel. Animals were sacrificed after 1.5hrs and BT, CT, PT, INR, APTT, plasma calcium levels were estimated. For ex vivo analyses, each 1ml blood aspirated was exposed to 0.1mg, 0.2mg, 0.3mg dose of hydergine with parallel controls. Parameters analyzed were as above. Statistical analysis was through one-way ANOVA. Dunken-s and Tukey-s tests provided intra-group variance. BT, CT, PT, INR and APTT increased while calcium levels dropped significantly (P
Abstract: The objective of the present research manuscript is to
perform parametric, nonparametric, and decision tree analysis to
evaluate two treatments that are being used for breast cancer patients.
Our study is based on utilizing real data which was initially used in
“Tamoxifen with or without breast irradiation in women of 50 years
of age or older with early breast cancer" [1], and the data is supplied
to us by N.A. Ibrahim “Decision tree for competing risks survival
probability in breast cancer study" [2]. We agree upon certain aspects
of our findings with the published results. However, in this
manuscript, we focus on relapse time of breast cancer patients instead
of survival time and parametric analysis instead of semi-parametric
decision tree analysis is applied to provide more precise
recommendations of effectiveness of the two treatments with respect
to reoccurrence of breast cancer.
Abstract: MMR vaccine failure had been reported globally and
here we report that it occurs now in India. Samples were collected from clinically suspected mumps cases were subjected for anti
mumps antibodies, virus isolation, RT-PCR, sequencing and
phylogenetic tree analysis. 56 samples collected from men and women belonging to various age groups. 30 had been vaccinated and
the status of 26 patients was unknown. 28 out of 30 samples were
found to be symptomatic and positive for Mumps IgM, indicating
active mumps infection in 93.4% of the vaccinated population. A
phylogenetic tree comparison of the clinical isolate is shown to be genotype C which is distinct from vaccine strain. Our study clearly sending warning signs that MMR vaccine is a failure and it needs to be revamped for the human use by increasing its efficacy and efficiency.
Abstract: With the rapid growth in business size, today-s businesses orient Throughout thirty years local, national and international experience in medicine as a medical student, junior doctor and eventually Consultant and Professor in Anaesthesia, Intensive Care and Pain Management, I note significant generalised dissatisfaction among medical students and doctors regarding their medical education and practice. We repeatedly hear complaints from patients about the dysfunctional health care system they are dealing with and subsequently the poor medical service that they are receiving. Medical students are bombarded with lectures, tutorials, clinical rounds and various exams. Clinicians are weighed down with a never-ending array of competing duties. Patients are extremely unhappy about the long waiting lists, loss of their records and the continuous deterioration of the health care service. This problem has been reported in different countries by several authors [1,2,3]. In a trial to solve this dilemma, a genuine idea has been suggested implementing computer technology in medicine [2,3]. Computers in medicine are a medium of international communication of the revolutionary advances being made in the application of the computer to the fields of bioscience and medicine [4,5]. The awareness about using computers in medicine has recently increased all over the world. In Misr University for Science & Technology (MUST), Egypt, medical students are now given hand-held computers (Laptop) with Internet facility making their medical education accessible, convenient and up to date. However, this trial still needs to be validated. Helping the readers to catch up with the on going fast development in this interesting field, the author has decided to continue reviewing the literature, exploring the state-of-art in computer based medicine and up dating the medical professionals especially the local trainee Doctors in Egypt. In part I of this review article we will give a general background discussing the potential use of computer technology in the various aspects of the medical field including education, research, clinical practice and the health care service given to patients. Hope this will help starting changing the culture, promoting the awareness about the importance of implementing information technology (IT) in medicine, which is a field in which such help is needed. An international collaboration is recommended supporting the emerging countries achieving this target.
Abstract: As a part of routine oesophageal HDR Brachytherapy procedure, treatment planning takes about 45 minutes while patients are under light sedation. Some patients may suffer gagging and/or spasms before the 90-minute brachytherapy procedure complete, and the treatment may need to be aborted. A pre-prepared plan generated before patient’s sedation may reduce the brachytherapy procedure time by 40 minutes. This paper reports rationality and evidence of pre-prepared treatment plans. A retrospective study of 28 patients confirms that pre-prepared plans would be acceptable for all reviewed patients. The rationality is further confirmed by a systemic study with a wide range of applicator curvature and treatment volume. Detailed comparison between CT based treatment plans and pre-prepared plans are discussed. The argument holds for endobronchial HDR brachytherapy too. With the above evidence, pre-prepared plans have been used for all oesophageal and endobronchial HDR brachytherapy cases in our clinic.
Abstract: The last decade has seen an early majority of people
The last decade, the role of the of the information communication
technologies has increased in improving the social and business life
of people. Today, it is recognized that game could contribute to
enhance virtual rehabilitation by better engaging patients. Our
research study aims to develop a game based system enhancing
cognitive and physical capabilities of elderly people. To this end, the
project aims to develop a low cost hand held system based on
existing game such as Wii, PSP, or Xbox. This paper discusses the
concepts and requirements for developing such game for elderly
people. Based on the requirement elicitation, we intend to develop a
prototype related to sport and dance activities.
Abstract: Hospitals in southern Hualien teamed with the
Hypertension Joint Care Network. Working with the network, the
team provided a special designed health education to the individual
who had been identified as a hypertension patient in the outpatient
department. Some metabolism improvements achieved. This is a
retrospective study by purposively taking 106 patients from a hospital
between 2008 and 2010. Records of before and after education
intervention of the objects was collected and analyzed to see the how
the intervention affected the patients- hypertension control via clinical
parameter monitoring. The results showed that the clinical indicators,
the LDL-C, the cholesterol and the systolic blood pressure were
significantly improved. The study provides evidence for the
effectiveness of the network in controlling hypertension.