Search results for: hospital laundry system.

Authors: Sheng Fu, Yinbo Gao, Hao Lin

Abstract:

In the current mine air compressors monitoring system, there are some difficulties in the installation and maintenance because of the wired connection. To solve the problem, this paper introduces a new air compressors monitoring system based on ZigBee in which the monitoring parameters are transmitted wirelessly. The collecting devices are designed to form a cluster network to collect vibration, temperature, and pressure of air cylinders and other parameters. All these devices are battery-powered. Besides, the monitoring software in PC is developed using MFC. Experiments show that the designed wireless sensor network works well in the site environmental condition and the system is very convenient to be installed since the wireless connection. This monitoring system will have a wide application prospect in the upgrade of the old monitoring system of the air compressors.

Keywords: Condition monitoring, wireless sensor network, air compressor, ZigBee, data collecting

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Authors: Mohd Ridhuan Tee Abdullah, Ong Hai Liaw, Wan Norhasniah Wan Husin

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The main issue discussed is on the role of education system in the process of nation building as a means in uniting different community ethnics which later on, hoped to shape the future ethnic relation of this country. It is generally known that political socialization experienced by each ethnic community has given birth to a vernacular education system, separated along the ethnic line. Every community shapes their own education system based on their respective mother tongue language, however all are based on the same curriculum. As a result the role of education as a uniting force is not significantly effective. Historically, it has been shown that government efforts to unite the country education system under the wing of national education system (national school) is not that successful since every community (Chinese) will defend the existence of their community education system because they want to spur their mother tongue language. The clash between national education system and vernacular education system is the root cause of stalemate in the ethnic relation in Malaysia and it always becomes a flash point when the issue is raised. The question now is what is the best solution to enhance the national education system in multiethnic Malaysia?

Keywords: Political socialization, education, national unity, national school, vernacular school and 1Malaysia

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Authors: Nareelux Suwannobol, JintanaTapin, Khuanchanok Narachan

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The objective of this study was to determine the accuracy to estimation fetal weight by Johnson-s method and compares it with actual birth weight. The sample group was 126 infants delivered in Dan KhunThot hospital from January March 2012. Fetal weight was estimated by measuring fundal height according to Johnson-s method. The information was collected by studying historical delivery records and then analyzed by using the statistics of frequency, percentage, mean, and standard deviation. Finally, the difference was analyzed by a paired t-test.The results showed had an average birth weight was 3093.57 ± 391.03 g (mean ± SD) and 3,455 ± 454.55 g average estimated fetal weight by Johnson-s method higher than average actual birth weight was 384.09 grams. When classifying the infants according to birth weight found that low birth weight (<2500 g) and the appropriate birth weight (2500-3999g) actual birth weight less than estimate fetal weight . But the high birth weight (> 4000 g) actual birth weight was more than estimated fetal weight. The difference was found between actual birth weight and estimation fetal weight of the minimum weight in high birth weight ( > 4000 g) , the appropriate birth weight (2500-3999g) and low birth weight (<2500 g) respectively. The rate of estimates fetal weight within 10% of actual birth weight was 35.7%. Actual birth weight were compared with the found that the difference is statistically significant (p <.000). Employing Johnson-s method to estimate fetal weight can estimate initial fetal weight before passing to special examinations, which may require excessive high cost. A variety of methods should be employed to estimate fetal weight more precisely, which will help plan care for mother-s and infant-s safety.

Keywords: Johnson's method, Fetal weight estimate, Delivery Room, Student nurse.

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Authors: Arazi Idrus, Christiono Utomo

Abstract:

This paper presents functionality of negotiation agent on value-based design decision. The functionality is based on the characteristics of the system and goal specification. A Prometheus Design Tool model was used for developing the system. Group functionality will be the attribute for negotiation agents, which comprises a coordinator agent and decision- maker agent. The results of the testing of the system to a building system selection on valuebased decision environment are also presented.

Keywords: Functionality, negotiation agent, value-baseddecision

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Authors: Devdutt, M. L. Aggarwal

Abstract:

The development of vehicles having best ride comfort and safety of travelling passengers is of great interest for automotive manufacturers. The effect of transmitted vibrations from car body to passenger seat is required to be controlled for achieving the same. The application of magneto-rheological (MR) shock absorber in suspension system has been considered to achieve significant benefits in this regard. This paper introduces a secondary suspension controlled semi-active quarter car system using MR shock absorber for effective vibration control. Fuzzy logic control system is used for design of controller for actual damping force generation by MR shock absorber. Performance evaluations are done related to passenger seat acceleration and displacement in time and frequency domains, in order to see the effectiveness of the proposed semi-active suspension system. Simulation results show that the semi-active suspension system provides better results compared to passive suspension system in terms of passenger ride comfort improvement.

Keywords: Fuzzy logic control, MR shock absorber, Quarter car model, Semi-active suspension system.

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Authors: Minho Ha, SeungHeo, Cheolung Cheong, Park K. Y.

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In this paper, a new cooling system using a nacelle duct is proposed for the mechanical room in the household refrigerator. The conventional mechanical room consists of a condenser, a compressor and an axial fan. The axial fan is mainly responsible for cooling the condenser and the compressor. The new cooling system is developed by replacing the axial fan with the nacelle duct including the small centrifugal fan. The parametric study is carried out to find the optimum designs of the nacelle duct in terms of performance and efficiency. Through this study, it is revealed that the new system can reduce the space, electrical power and noise compared with the conventional system

Keywords: Centrifugal Fan, Cooling Fan, Nacelle Duct, Refrigerator

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Authors: Janet L. Kourik, Peter E. Maher

Abstract:

To investigate the correspondence of theory and practice, a successfully implemented Knowledge Management System (KMS) is explored through the lens of Alavi and Leidner-s proposed KMS framework for the analysis of an information system in knowledge management (Framework-AISKM). The applied KMS system was designed to manage curricular knowledge in a distributed university environment. The motivation for the KMS is discussed along with the types of knowledge necessary in an academic setting. Elements of the KMS involved in all phases of capturing and disseminating knowledge are described. As the KMS matures the resulting data stores form the precursor to and the potential for knowledge mining. The findings from this exploratory study indicate substantial correspondence between the successful KMS and the theory-based framework providing provisional confirmation for the framework while suggesting factors that contributed to the system-s success. Avenues for future work are described.

Keywords: Applied KMS, education, knowledge management (KM), KM framework, knowledge management system (KMS).

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Authors: Aarati Susan Mathew, Radhika Narendra Patel, Jiji Mathew

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A retrospective study conducted at Christian Medical College (CMC) Teaching Hospital, Vellore, India on 14th August 2014 to assess the accuracy of clinically estimated foetal weight upon labour admission. Estimating foetal weight is a crucial factor in assessing maternal and foetal complications during and after labour. Medical notes of ninety-eight postnatal women who fulfilled the inclusion criteria were studied to evaluate the correlation between their recorded Estimated Foetal Weight (EFW) on admission and actual birth weight (ABW) of the newborn after delivery. Data concerning maternal and foetal demographics was also noted. Accuracy was determined by absolute percentage error and proportion of estimates within 10% of ABW. Actual birth weights ranged from 950-4080g. A strong positive correlation between EFW and ABW (r=0.904) was noted. Term deliveries (≥40 weeks) in the normal weight range (2500-4000g) had a 59.5% estimation accuracy (n=74) compared to pre-term (<40 weeks) with an estimation accuracy of 0% (n=2). Out of the term deliveries, macrosomic babies (>4000g) were underestimated by 25% (n=3) and low birthweight (LBW) babies were overestimated by 12.7% (n=9). Registrars who estimated foetal weight were accurate in babies within normal weight ranges. However, there needs to be an improvement in predicting weight of macrosomic and LBW foetuses. We have suggested the use of an amended version of the Johnson’s formula for the Indian population for improvement and a need to re-audit once implemented.

Keywords: Clinical palpation, estimated foetal weight, pregnancy, India, Johnson’s formula.

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Authors: Tajul Urus, S., Molla, A., Teoh, S.Y.

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A number of studies highlighted problems related to ERP systems, yet, most of these studies focus on the problems during the project and implementation stages but not during the postimplementation use process. Problems encountered in the process of using ERP would hinder the effective exploitation and the extended and continued use of ERP systems and their value to organisations. This paper investigates the different types of problems users (operational, supervisory and managerial) faced in using ERP and how 'feral system' is used as the coping mechanism. The paper adopts a qualitative method and uses data collected from two cases and 26 interviews, to inductively develop a casual network model of ERP usage problem and its coping mechanism. This model classified post ERP usage problems as data quality, system quality, interface and infrastructure. The model is also categorised the different coping mechanism through use of 'feral system' inclusive of feral information system, feral data and feral use of technology.

Keywords: Case Studies, Coping Mechanism, Post Implementation ERP system, Usage Problem

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Authors: Guangbin Wang, Ning Zhang, Fuping Tan

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In this paper, we present parallel alternating two-stage methods for solving linear system Ax = b, where A is a monotone matrix or an H-matrix. And we give some convergence results of these methods for nonsingular linear system.

Keywords: Parallel, alternating two-stage, convergence, linear system.

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Authors: B.-Y.-S. Lau, Y.-C.-T. Jonathan, M.-S. Alias

Abstract:

Heritage trees are natural large, individual trees with exceptionally value due to association with age or event or distinguished people. In Malaysia, there is an abundance of tropical heritage trees throughout the country. It is essential to set up a repository of heritage trees to prevent valuable trees from being cut down. In this cross domain study, a web-based online expert system namely the Heritage Tree Expert Assessment and Classification (HTEAC) is developed and deployed for public to nominate potential heritage trees. Based on the nomination, tree care experts or arborists would evaluate and verify the nominated trees as heritage trees. The expert system automatically rates the approved heritage trees according to pre-defined grades via Delphi technique. Features and usability test of the expert system are presented. Preliminary result is promising for the system to be used as a full scale public system.

Keywords: Arboriculture, Delphi, expert system, heritage tree, urban forestry.

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Authors: H. Rezzouk, M. Hatti, H. Rahmani, S. Atoui

Abstract:

This paper discusses the design and analysis of a hybrid PV-Fuel cell energy system destined to power a DC load. The system is composed of a photovoltaic array, a fuel cell, an electrolyzer and a hydrogen tank. HOMER software is used in this study to calculate the optimum capacities of the power system components that their combination allows an efficient use of solar resource to cover the hourly load needs. The optimal system sizing allows establishing the right balance between the daily electrical energy produced by the power system and the daily electrical energy consumed by the DC load using a 28 KW PV array, a 7.5 KW fuel cell, a 40KW electrolyzer and a 270 Kg hydrogen tank. The variation of powers involved into the DC bus of the hybrid PV-fuel cell system has been computed and analyzed for each hour over one year: the output powers of the PV array and the fuel cell, the input power of the elctrolyzer system and the DC primary load. Equally, the annual variation of stored hydrogen produced by the electrolyzer has been assessed. The PV array contributes in the power system with 82% whereas the fuel cell produces 18%. 38% of the total energy consumption belongs to the DC primary load while the rest goes to the electrolyzer.

Keywords: Electrolyzer, Hydrogen, Hydrogen Fueled Cell, Photovoltaic.

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Authors: A. Charlangsut, M. Boonthienthong, N. Rugthaicharoencheep

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This paper proposes a mathematical model for transmission expansion employing optimization method with scenario analysis approach. Economic transmission planning, on the other hand, seeks investment opportunities so that network expansions can generate more economic benefits than the costs. This approach can be used as a decision model for building new transmission lines added to the existing transmission system minimizing costs of the entire system subject to various system’s constraints and consider of loss value of transmission system and N-1 checking. The results show that the proposed model is efficient to be applied for the larger scale of power system topology.

Keywords: Transmission Expansion Planning, Economic Dispatch, Scenario Analysis, Contingency.

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Authors: Khelood A. Mkalaf, Peter Gibson, John Flanagan

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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.

Keywords: Critical medical equipment, maintenance strategy, patient outcomes, reliability.

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Authors: Roscoe McLean, Jared Padayachee, Glen Bright

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There is currently a gap in the technology covering the rapid establishment of control after a reconfiguration in a Reconfigurable Manufacturing System. This gap involves the detection of the factory floor state and the communication link between the factory floor and the high-level software. In this paper, a thin, hardware-supported Middleware Management System (MMS) is proposed and its design and implementation are discussed. The research found that a cost-effective localization technique can be combined with intelligent software to speed up the ramp-up of a reconfigured system. The MMS makes the process more intelligent, more efficient and less time-consuming, thus supporting the industrial implementation of the RMS paradigm.

Keywords: Intelligent systems, middleware, reconfigurable manufacturing.

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Authors: S. Sendhil Kumar, S. N. Vijayan

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Utilization of solar energy can be found in various domestic and industrial applications. The performance of any solar collector is largely affected by various parameters such as glazing, absorber plate, top covers, and heating pipes. Technology improvements have brought us another method for conversion of solar energy to direct electricity using solar photovoltaic system. Utilization and extraction of solar energy is the biggest problem in these conversion methods. This paper aims to overcome these problems and take the advantages of available energy from solar by maximizing the utilization through solar tracking system using a refrigerant as a working medium. The use of this tracking system can help increase the efficiency of conversion devices by maximum utilization of solar energy. The dual axis tracking system gives maximum energy output compared to single axis tracking system.

Keywords: Refrigerant, solar collector, solar energy, solar panel, solar tracking.

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Authors: Cuiran Li, Jianli Xie, Chengshu Li

Abstract:

Multicarrier code-division multiple-access is one of the effective techniques to gain its multiple access capability, robustness against fading, and to mitigate the ISI. In this paper, we propose an improved mulcarrier CDMA system with adaptive subchannel allocation. We analyzed the performance of our proposed system in frequency selective fading environment with narrowband interference existing and compared it with that of parallel transmission over many subchannels (namely, conventional MC-CDMA scheme) and DS-CDMA system. Simulation results show that adaptive subchannel allocation scheme, when used in conventional multicarrier CDMA system, the performance will be greatly improved.

Keywords: MC-CDMA, Rayleigh fading, Narrowbandinterference, Channel estimation.

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Authors: A. Youseef, F. Liu

Abstract:

The existing information system (IS) developments methods are not met the requirements to resolve the security related IS problems and they fail to provide a successful integration of security and systems engineering during all development process stages. Hence, the security should be considered during the whole software development process and identified with the requirements specification. This paper aims to propose an integrated security and IS engineering approach in all software development process stages by using i* language. This proposed framework categorizes into three separate parts: modelling business environment part, modelling information technology system part and modelling IS security part. The results show that considering security IS goals in the whole system development process can have a positive influence on system implementation and better meet business expectations.

Keywords: Business Process Modelling (BPM), Information System Security, Software Development Process, Requirement Engineering.

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Authors: Ionel Stanculeanu, Theodor Borangiu

Abstract:

This paper presents a new approach in the identification of the quadrotor dynamic model using a black-box system for identification. Also the paper considers the problems which appear during the identification in the closed-loop and offers a technical solution for overcoming the correlation between the input noise present in the output

Keywords: System identification, UAV, prediction error method, quadrotor.

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Authors: M. H. M. Rusli, A. Jaffar, M. T. Ali, S. Muhamud @ Kayat

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Lean manufacturing is a production philosophy made popular by Toyota Motor Corporation (TMC). It is globally known as the Toyota Production System (TPS) and has the ultimate aim of reducing cost by thoroughly eliminating wastes or muda. TPS embraces the Just-in-time (JIT) manufacturing; achieving cost reduction through lead time reduction. JIT manufacturing can be achieved by implementing Pull system in the production. Furthermore, TPS aims to improve productivity and creating continuous flow in the production by arranging the machines and processes in cellular configurations. This is called as Cellular Manufacturing Systems (CMS). This paper studies on integrating the CMS with the Pull system to establish a Big Island-Pull system production for High Mix Low Volume (HMLV) products in an automotive component industry. The paper will use the build-in JIT system steps adapted from TMC to create the Pull system production and also create a shojinka line which, according to takt time, has the flexibility to adapt to demand changes simply by adding and taking out manpower. This will lead to optimization in production.

Keywords: Big Island layout, Lean manufacturing, Material and Information Flow Chart, Pull system production, TPS.

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Authors: Osamah A. Alsayegh

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Kuwait-s electric power system is vertically integrated organization owned and operated by the government. For more than five decades, the government of Kuwait has provided relatively reliable electric services to consumers with subsidized electric service fees. Given the country-s rapid socio-economical development and consequently the increase of electricity demand, a question that inflicts itself: Is it necessary to reform the power system to face the fast growing demand? This paper recommends that the government should consider the private sector as a partner in operating the power system. Therefore, power system restructuring is needed to allow such partnership. There are challenges that prevent such restructuring. Abstract recommendations toward resolving these challenges are proposed.

Keywords: Deregulation, electricity market, ISO, private sector.

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Authors: Essa Alenazi, Zulfikar Adamu

Abstract:

The Kingdom of Saudi Arabia (KSA) is not an exception in relying on the growth of its construction industry to support rapid population growth. However, its need for infrastructure development is constrained by low productivity levels and cost overruns caused by factors such as delays to project completion. Delays in delivering a construction project are a global issue and while theories such as Optimism Bias have been used to explain such delays, in KSA, client-related causes of delays are also significant. The objective of this paper is to develop a framework-based approach to explore how the country’s construction industry can manage and reduce delays in construction projects through building information modelling (BIM) in order to mitigate the cost consequences of such delays.  It comprehensively and systematically reviewed the global literature on the subject and identified gaps, critical delay factors and the specific benefits that BIM can deliver for the delay management.  A case study comprising of nine hospital projects that have experienced delay and cost overruns was also carried out. Five critical delay factors related to the clients were identified as candidates that can be mitigated through BIM’s benefits. These factors are: Ineffective planning and scheduling of the project; changes during construction by the client; delay in progress payment; slowness in decision making by the client; and poor communication between clients and other stakeholders. In addition, data from the case study projects strongly suggest that optimism bias is present in many of the hospital projects. Further validation via key stakeholder interviews and documentations are planned.

Keywords: BIM, client perspective, delay management, optimism bias, public sector projects.

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Authors: Quoc-Nam Tran, Anjib Mulepati

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Validation of an automation system is an important issue. The goal is to check if the system under investigation, modeled by a Petri net, never enters the undesired states. Usually, tools dedicated to Petri nets such as DESIGN/CPN are used to make reachability analysis. The biggest problem with this approach is that it is impossible to generate the full occurence graph of the system because it is too large. In this paper, we show how computational methods such as temporal logic model checking and Groebner bases can be used to verify the correctness of the design of an automation system. We report our experimental results with two automation systems: the Automated Guided Vehicle (AGV) system and the traffic light system. Validation of these two systems ranged from 10 to 30 seconds on a PC depending on the optimizing parameters.

Keywords: Computational Intelligence, Temporal Logic Reasoning, Model Checking, Groebner Bases.

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Authors: Wenjuan Du

Abstract:

The phase compensation method was proposed based on the concept of the damping torque analysis (DTA). It is a method for the design of a PSS (power system stabilizer) to suppress local-mode power oscillations in a single-machine infinite-bus power system. This paper presents the application of the phase compensation method for the design of a PSS in a multi-machine power system. The application is achieved by examining the direct damping contribution of the stabilizer to the power oscillations. By using linearized equal area criterion, a theoretical proof to the application for the PSS design is presented. Hence PSS design in the paper is an example of stable tending control by localized method.

Keywords: Phase compensation method, power system small-signal stability, power system stabilizer.

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Authors: Abdur Rosyid, Mohamed El-Madany, Mohanad Alata

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Due to simplicity and low cost, rotordynamic system is often modeled by using lumped parameters. Recently, finite elements have been used to model rotordynamic system as it offers higher accuracy. However, it involves high degrees of freedom. In some applications such as control design, this requires higher cost. For this reason, various model reduction methods have been proposed. This work demonstrates the quality of model reduction of rotor-bearing-support system through substructuring. The quality of the model reduction is evaluated by comparing some first natural frequencies, modal damping ratio, critical speeds, and response of both the full system and the reduced system. The simulation shows that the substructuring is proven adequate to reduce finite element rotor model in the frequency range of interest as long as the number and the location of master nodes are determined appropriately. However, the reduction is less accurate in an unstable or nearly-unstable system.

Keywords: Finite element model, rotordynamic system, model reduction, substructuring.

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Authors: D. Pinto, L. Castro, M.L. Cruzat, S. Barros, J. Gironás, C. Oberli, M. Torres, C. Escauriaza, A. Cipriano

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Flash Floods, together with landslides, are a common natural threat for people living in mountainous regions and foothills. One way to deal with this constant menace is the use of Early Warning Systems, which have become a very important mitigation strategy for natural disasters. In this work we present our proposal for a pilot Flash Flood Early Warning System for Santiago, Chile, the first stage of a more ambitious project that in a future stage shall also include early warning of landslides. To give a context for our approach, we first analyze three existing Flash Flood Early Warning Systems, focusing on their general architectures. We then present our proposed system, with main focus on the decision support system, a system that integrates empirical models and fuzzy expert systems to achieve reliable risk estimations.

Keywords: Decision Support System, Early Warning Systems, Flash Flood, Natural Hazard.

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Authors: Nora Taghavi, Ali Sadr

Abstract:

System identification is the process of creating models of dynamic process from input- output signals. The aim of system identification can be identified as “ to find a model with adjustable parameters and then to adjust them so that the predicted output matches the measured output". This paper presents a method of modeling and simulating with system identification to achieve the maximum fitness for transformation function. First by using optimized KLM equivalent circuit for PVDF piezoelectric transducer and assuming different inputs including: sinuside, step and sum of sinusides, get the outputs, then by using system identification toolbox in MATLAB, we estimate the transformation function from inputs and outputs resulted in last program. Then compare the fitness of transformation function resulted from using ARX,OE(Output- Error) and BJ(Box-Jenkins) models in system identification toolbox and primary transformation function form KLM equivalent circuit.

Keywords: PVDF modeling, ARX, BJ(Box-Jenkins), OE(Output-Error), System Identification.

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Authors: Muhammad Tahir Qadri, M. Irfan Anis, M. Nawaz Irshad Khan

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This paper discusses the approach of real-time controlling of the energy management system using the data acquisition tool of LabVIEW. The main idea of this inspiration was to interface the Station (PC) with the system and publish the data on internet using LabVIEW. In this venture, controlling and switching of 3 phase AC loads are effectively and efficiently done. The phases are also sensed through devices. In case of any failure the attached generator starts functioning automatically. The computer sends command to the system and system respond to the request. The modern feature is to access and control the system world-wide using world wide web (internet). This controlling can be done at any time from anywhere to effectively use the energy especially in developing countries where energy management is a big problem. In this system totally integrated devices are used to operate via remote location.

Keywords: VI-server, Remote Access, Telemetry, Data Acquisition, web server.

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Authors: Thach D. Do, Juhum Kwon, Chang-Joo Moon

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A Ground Control System (GCS), which controls Unmanned Aerial Vehicles (UAVs) and monitors their missionrelated data, is one of the major components of UAVs. In fact, some traditional GCSs were built on an expensive, complicated hardware infrastructure with workstations and PCs. In contrast, a GCS on a portable device – such as an Android phone or tablet – takes advantage of its light-weight hardware and the rich User Interface supported by the Android Operating System. We implemented that kind of GCS and called it Ground System Software (GSS) in this paper. In operation, our GSS communicates with UAVs or other GSS via TCP/IP connection to get mission-related data, visualizes it on the device-s screen, and saves the data in its own database. Our study showed that this kind of system will become a potential instrument in UAV-related systems and this kind of topic will appear in many research studies in the near future.

Keywords: Android Operating System, Ground Control System, Mobile Device, Unmanned Aerial Vehicle.

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Authors: Z. Nurzaireena, K. Azalea, T. Azirawaty, S. Jameela, G. Muralitharan

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The aim of this study is the review of the management practices of sickle cell disease patients during pregnancy, as well as the maternal and neonatal outcome at Ampang Hospital, Selangor. The study consisted of a review of pregnant patients with sickle cell disease under follow up at the Hematology Clinic, Ampang Hospital over the last seven years to assess their management and maternal-fetal outcome. The results of the review show that Ampang Hospital is considered the public hematology centre for sickle cell disease and had successfully managed three pregnancies throughout the last seven years. Patients’ presentations, managements and maternal-fetal outcome were compared and reviewed for academic improvements. All three patients were seen very early in their pregnancy and had been given a regime of folic acid, antibiotics and thrombo-prophylactic drugs. Close monitoring of maternal and fetal well being was done by the hematologists and obstetricians. Among the patients, there were multiple admissions during the pregnancy for either a painful sickle cell bone crisis, haemolysis following an infection and anemia requiring phenotype- matched blood and exchange transfusions. Broad spectrum antibiotics coverage during and infection, hydration, pain management and venous-thrombolism prophylaxis were mandatory. The pregnancies managed to reach near term in the third trimester but all required emergency caesarean section for obstetric indications. All pregnancies resulted in live births with good fetal outcome. During post partum all were nursed closely in the high dependency units for further complications and were discharged well. Post partum follow up and contraception counseling was comprehensively given for future pregnancies. Sickle cell disease is uncommonly seen in the East, especially in the South East Asian region, yet more cases are seen in the current decade due to improved medical expertise and advance medical laboratory technologies. Pregnancy itself is a risk factor for sickle cell patients as increased thrombosis event and risk of infections can lead to multiple crisis, haemolysis, anemia and vaso-occlusive complications including eclampsia, cerebrovasular accidents and acute bone pain. Patients mostly require multiple blood product transfusions thus phenotype-matched blood is required to reduce the risk of alloimmunozation. Emphasizing the risks and complications in preconception counseling and establishing an ultimate pregnancy plan would probably reduce the risk of morbidity and mortality to the mother and unborn child. Early management for risk of infection, thromboembolic events and adequate hydration is mandatory. A holistic approach involving multidisciplinary team care between the hematologist, obstetricians, anesthetist, neonatologist and close nursing care for both mother and baby would ensure the best outcome. In conclusion, sickle cell disease by itself is a high risk medical condition and pregnancy would further amplify the risk. Thus, close monitoring with combine multidisciplinary care, counseling and educating the patients are crucial in achieving the safe outcome.

Keywords: Anemia, haemoglobinopathies, pregnancy, sickle cell disease.

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