Search results for: Patients

Authors: Mawahib Gafare Abdalrahman Ahmed, Abdallah Belal Adam, John Ojur Dennis

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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.

Keywords: Air bubbles, Hemodialysis, Capacitor, Dextran70, Air bubbles diameters.

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Authors: Sabrina Azzi, Michal Iglewski, Véronique Nabelsi

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Diagnosis error problem is frequent and one of the most important safety problems today. One of the main objectives of our work is to propose an ontological representation that takes into account the diagnostic criteria in order to improve the diagnostic. We choose pneumonia disease since it is one of the frequent diseases affected by diagnosis errors and have harmful effects on patients. To achieve our aim, we use a semi-automated method to integrate diverse knowledge sources that include publically available pneumonia disease guidelines from international repositories, biomedical ontologies and electronic health records. We follow the principles of the Open Biomedical Ontologies (OBO) Foundry. The resulting ontology covers symptoms and signs, all the types of pneumonia, antecedents, pathogens, and diagnostic testing. The first evaluation results show that most of the terms are covered by the ontology. This work is still in progress and represents a first and major step toward a development of a diagnosis decision support system for pneumonia.

Keywords: Clinical decision support system, diagnostic errors, ontology, pneumonia.

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Authors: Fareeha A., Irfan Z Qureshi

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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<0.05). Ex vivo, CT, PT and APTT were elevated while plasma calcium levels lowered significantly (P<0.05). Our study suggests that hydergine may act as a thrombolytic agent but warrants further studies to elucidate this role of ergot mesylates.

Keywords: Hydergine, Coagulation assays, plasma calcium, ergot mesylates, thrombosis.

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Authors: Leonardo Juan Ramírez López, Javier Oswaldo Rodriguez Velasquez

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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.

Keywords: Entropy, mathematical, prediction, cardiac, holter, attractor.

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Authors: A. Meeprasert, W. Khuntawee, S. Hannongbua, T. Rungrotmongkol

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Viral influenza A subtypes H5N1 and pandemic H1N1 (pH1N1) have worldwide emerged and transmitted. The most common anti-influenza drug for treatment of both seasonal and pandemic influenza viruses is oseltamivir that nowadays becomes resistance to influenza neuraminidase. The novel long-acting drug, laninamivir, was discovered for treatment of the patients infected with influenza B and influenza A viruses. In the present study, laninamivir complexed with wild-type strain of both H5N1 and pH1N1 viruses were comparatively determined the structures and drug-target interactions by means of molecular dynamics (MD) simulations. The results show that the hydrogen bonding interactions formed between laninamivir and its binding residues are likely similar for the two systems. Additionally, the presence of intermolecular interactions from laninamivir to the residues in the binding pocket is established through their side chains in accordance with hydrogen bond interactions.

Keywords: Laninamivir, neuraminidase, H5N1, pandemic H1N1, wild-type, MD simulation

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Authors: Cristina G. Dascalu, Elena Mihaela Carausu, Daniela Manuc

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The medical studies often require different methods for parameters selection, as a second step of processing, after the database-s designing and filling with information. One common task is the selection of fields that act as risk factors using wellknown methods, in order to find the most relevant risk factors and to establish a possible hierarchy between them. Different methods are available in this purpose, one of the most known being the binary logistic regression. We will present the mathematical principles of this method and a practical example of using it in the analysis of the influence of 10 different psychiatric diagnostics over 4 different types of offences (in a database made from 289 psychiatric patients involved in different types of offences). Finally, we will make some observations about the relation between the risk factors hierarchy established through binary logistic regression and the individual risks, as well as the results of Chi-squared test. We will show that the hierarchy built using the binary logistic regression doesn-t agree with the direct order of risk factors, even if it was naturally to assume this hypothesis as being always true.

Keywords: Databases, risk factors, binary logisticregression, hierarchy.

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Authors: Shweta Singh, Dipali Bansal, Rashima Mahajan

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Psychoacoustics has become a potential area of research due to the growing interest of both laypersons and medical and mental health professionals. Non invasive brain computer interface like Electroencephalography (EEG) is widely being used in this field. An attempt has been made in this paper to examine the response of EEG signals to acoustic stimuli further analyzing the brain electrical activity. The real time EEG is acquired for 6 participants using a cost effective and portable EMOTIV EEG neuro headset. EEG data analysis is further done using EMOTIV test bench, EDF browser and EEGLAB (MATLAB Tool) application software platforms. Spectral analysis of acquired neural signals (AF3 channel) using these software platforms are clearly indicative of increased brain activity in various bands. The inferences drawn from such an analysis have significant correlation with subject’s subjective reporting of the experiences. The results suggest that the methodology adopted can further be used to assist patients with sleeping and depressive disorders.

Keywords: OM’ chant, Spectral analysis, EDF Browser, EEGLAB, EMOTIV, Real time Acquisition.

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Authors: B. Michelle Sweeting

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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 <24 hours uneventfully. All cases remained without residual complaints upon follow-up. Results showed that although respiration difficulty was perceived as the most detrimental of presenting complaints, it was noted to be mostly subjective with benign outcome.

Keywords: Acute Pepper Spray Inhalation, Capsaicinoids, Oleoresin Capsicum, Pepper spray, Respiratory severity severity.

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Authors: Zeinep A. Berkimbayeva, Almagul T. Mansharipova, Elmira M. Khussainova, Leyla B. Djansugurova

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It is believed that DNA damaging toxic metabolites contributes to the development of different pathological conditions. To prevent harmful influence of toxic agents, cells developed number of protecting mechanisms, such as enzymatic reaction of detoxification of reactive metabolites and repair of DNA damage. The aim of the study was to examine the association between polymorphism of GSTT1/GSTM1 and XRCC1/3 genes and coronary artery disease (CAD) incidence. To examine a polymorphism of these genes in CAD susceptibility in patients and controls, PCR based genotyping assay was performed. For GST genes, frequency of GSTM1 null genotype among CAD affected group was significantly increased than in control group (P<0.001). Frequencies of the GSTT1 null and positive alleles are almost equal in both groups (P>0.1). We found that neither XRCC1 Arg399Gln nor XRCC3 Thr241Met were associated with CAD risk. Obtained data suggests that GSTM1 null genotype carriers are more susceptible to CAD development.

Keywords: Cardiovascular disease, DNA reparation, gene polymorphism, risk factors, xenobiotic detoxification.

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Authors: Firas Salih, Luban Hameed, Afaf Kamil, Armin Bolz

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Diagnostic and detection of the arterial stiffness is very important; which gives indication of the associated increased risk of cardiovascular diseases. To make a cheap and easy method for general screening technique to avoid the future cardiovascular complexes , due to the rising of the arterial stiffness ; a proposed algorithm depending on photoplethysmogram to be used. The photoplethysmograph signals would be processed in MATLAB. The signal will be filtered, baseline wandering removed, peaks and valleys detected and normalization of the signals should be achieved .The area under the catacrotic phase of the photoplethysmogram pulse curve is calculated using trapezoidal algorithm ; then will used in cooperation with other parameters such as age, height, blood pressure in neural network for arterial stiffness detection. The Neural network were implemented with sensitivity of 80%, accuracy 85% and specificity of 90% were got from the patients data. It is concluded that neural network can detect the arterial STIFFNESS depending on risk factor parameters.

Keywords: Arterial stiffness, area under the catacrotic phase of the photoplethysmograph pulse, neural network

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Authors: John Tolentino, Yong Seok Park

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There are currently many people living with limb loss in the USA. The main causes for amputation can range from vascular disease, to trauma, or cancer. This number is expected increase over the next decade. Many patients have a single prosthetic for the first year but end up getting a second one to accommodate their changing physique. Afterwards, the prosthesis gets replaced every three to five years depending on how often it is used. This could cost the patient up to $500,000 throughout their lifetime. Complications do not end there, however. Due to the absence of nerves, it becomes more difficult to traverse terrain with a prosthetic. Moving on an incline or decline becomes difficult, thus curbs and stairs can be a challenge. Certain physical activities, such as cycling, could be even more strenuous. It will need to be relearned to accommodate for the change in weight, center of gravity, and transfer of energy from the leg to the pedal. The purpose of this research project is to develop a new, alternate below-knee cycling prosthetic using Dieter & Schmidt’s design process approach. It will be subjected to fatigue analysis under dynamic loading to observe the limitations as well as the strengths and weaknesses of the prosthetic. Benchmark comparisons will be made between existing prosthetics and the proposed one, examining the benefits and disadvantages. The resulting prosthetic will be 3D printed using acrylonitrile butadiene styrene (ABS) or polycarbonate (PC) plastic.

Keywords: 3D printing, cycling, prosthetic design, synthetic design.

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Authors: Zeeshan Hamid, Asher Ramish

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The purpose of this paper is to focus on security and safety issues facing by pharmaceutical industry globally when counterfeit drugs are in question. Hence, there is an intense need to secure and authenticate pharmaceutical products in the emerging counterfeit product market. This paper will elaborate the application of radio frequency identification (RFID) in pharmaceutical industry and to identify its key benefits for patient’s care. The benefits are: help to co-ordinate the stream of supplies, accuracy in chains of supplies, maintaining trustworthy information, to manage the operations in appropriate and timely manners and finally deliver the genuine drug to patient. It is discussed that how RFID supported supply chain information sharing (SCIS) helps to combat against counterfeit drugs. And a solution how to tag pharmaceutical products; since, some products prevent RFID implementation in this industry. In this paper, a proposed model for pharma industry distribution suggested to combat against the counterfeit drugs when they are in supply chain.

Keywords: Supply chain, RFID, pharmaceutical industry, counterfeit drugs, patients care.

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Authors: Liping Li, Ke Li, Changchun Liu, Chengyu Liu, Yuanyang Li

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A five-class density histogram with an index named cumulative density was proposed to analyze the short-term HRV. 150 subjects participated in the test, falling into three groups with equal numbers -- the healthy young group (Young), the healthy old group (Old), and the group of patients with congestive heart failure (CHF). Results of multiple comparisons showed a significant differences of the cumulative density in the three groups, with values 0.0238 for Young, 0.0406 for Old and 0.0732 for CHF (p<0.001). After 7 days and 14 days, 46 subjects from the Young and Old groups were retested twice following the same test protocol. Results showed good-to-excellent interclass correlations (ICC=0.783, 95% confidence interval 0.676-0.864). The Bland-Altman plots were used to reexamine the test-retest reliability. In conclusion, the method proposed could be a valid and reliable method to the short-term HRV assessment.

Keywords: Autonomic nervous system, congestive heart failure, heart rate variability, histogram.

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Authors: Anwar Sadat

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Today, the Internet based communication has widen the opportunity of event monitoring system in the medical field. There is always a need of analyzing and designing secure and reliable mobile communication between the hospital and biomedical engineers mobile units. This study has been carried out to find possible solution using SIP-based event notification for alerting the technical staff about the Biomedical Device (BMD) status and Patients treatment session. The Session Initiation Protocol (SIP) can be used to create a medical event notification system. SIP can work on a variety of devices. Its adoption as the protocol of choice for third generation wireless networks allows for a robust and scalable environment. One of the advantages of SIP is that it supports personal mobility through the separation of user addressing and device addressing. The solution for Telemed alert notification system is based on SIP - Specific Event Notification. The aim of this project is to extend mobility service to the hospital technicians who are using Telemedicine system.

Keywords: Biomedical, Mobility Service, Notify, Proxy Server, SIP, Subscribe, Telemedicine.

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Authors: Sh. Yasini, M. B. Naghibi-Sistani, A. Karimpour

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This paper employs a new approach to regulate the blood glucose level of type I diabetic patient under an intensive insulin treatment. The closed-loop control scheme incorporates expert knowledge about treatment by using reinforcement learning theory to maintain the normoglycemic average of 80 mg/dl and the normal condition for free plasma insulin concentration in severe initial state. The insulin delivery rate is obtained off-line by using Qlearning algorithm, without requiring an explicit model of the environment dynamics. The implementation of the insulin delivery rate, therefore, requires simple function evaluation and minimal online computations. Controller performance is assessed in terms of its ability to reject the effect of meal disturbance and to overcome the variability in the glucose-insulin dynamics from patient to patient. Computer simulations are used to evaluate the effectiveness of the proposed technique and to show its superiority in controlling hyperglycemia over other existing algorithms

Keywords: Insulin Delivery rate, Q-learning algorithm, Reinforcement learning, Type I diabetes.

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Authors: A. Alhazza, B. Alnaser

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Orthodontic restorative materials are widely used for the direct restoration of teeth or for cosmetic dentistry purposes. These materials have helped to solve many dental problems, providing healthy and beautiful smiles for many patients. In this study, we aimed to investigate whether the pH value has an effect on the surface structure of a nanohybrid composite material. Five different types of highly consumed beverages were selected to examine their effect on the surface structure of the nanohybrid composite material. The beverages had different pH values in the range of 3–6, i.e., they were all acidic. The material was investigated under the hardest conditions of surface exposure to the drinks by immersing the material for a long period. The specimens were examined using scanning electron microscopy (SEM) at different magnifications to investigate the effect of these beverages on the morphology of the nanohybrid composite material discs. All specimens showed an effect including pores, cracks, protrusions, and surface roughness as a result of the beverages. The degree of effect differed from one experimental group to another, but there was no relationship between the pH (acidity) value and the degree of effect on the surface structure of the specimens.

Keywords: Acidity, beverage, SEM, dentistry.

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Authors: Kasra Afsahi, Maryam Soheilifar, Noureddin Nakhostin Ansari

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COVID-19 has been associated with stroke and neurological complications. The patient was a 59-year-old male presented with sudden left hemiparesis and diplopia due to cavernous sinus thrombosis (CST) on 28/03/2020. The COVID-19 test was positive. Multislice computerized tomography (MSCT) showed ischemic infarction. He underwent surgical sinectomy 9 days after admission. Physiotherapy began for him on August 2020. Our game-based virtual reality (VR) technology developed for stroke patients was based on upper extremity exercises and function for stroke. After 6 weeks of VR therapy plus conventional physiotherapy exercises (18 sessions, three times per week, 60 minutes each session), there were significant improvements in Brunnstrom Motor Recovery Stage (from “4” to “5”), Fugl-Meyer Scale score of upper extremity section (from 49 to 54), and Modified Barthel Index (from 15 to 18). There were no adverse effects. This case with stroke post COVID-19 due to the CST showed the usefulness of VR therapy used as an adjunct to conventional physiotherapy in improving affected upper extremity.

Keywords: COVID-19, stroke, virtual reality, rehabilitation.

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Authors: L. Salhi, M. Talbi, A. Cherif

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This paper presents a new strategy of identification and classification of pathological voices using the hybrid method based on wavelet transform and neural networks. After speech acquisition from a patient, the speech signal is analysed in order to extract the acoustic parameters such as the pitch, the formants, Jitter, and shimmer. Obtained results will be compared to those normal and standard values thanks to a programmable database. Sounds are collected from normal people and patients, and then classified into two different categories. Speech data base is consists of several pathological and normal voices collected from the national hospital “Rabta-Tunis". Speech processing algorithm is conducted in a supervised mode for discrimination of normal and pathology voices and then for classification between neural and vocal pathologies (Parkinson, Alzheimer, laryngeal, dyslexia...). Several simulation results will be presented in function of the disease and will be compared with the clinical diagnosis in order to have an objective evaluation of the developed tool.

Keywords: Formants, Neural Networks, Pathological Voices, Pitch, Wavelet Transform.

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Authors: Naoto Suzuki

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To distinguish small retinal hemorrhages in early diabetic retinopathy from dust artifacts, we analyzed hue, lightness, and saturation (HLS) color spaces. The fundus of 5 patients with diabetic retinopathy was photographed. For the initial experiment, we placed 4 different colored papers on the ceiling of a darkroom. Using each color, 10 fragments of house dust particles on a magnifier were photographed. The colored papers were removed, and 3 different colored light bulbs were suspended from the ceiling. Ten fragments of house dust particles on the camera-s object lens were photographed. We then constructed an experimental device that can photograph artificial eyes. Five fragments of house dust particles under the ocher fundus of the artificial eye were photographed. On analyzing HLS color space of the dust artifact, lightness and saturation were found to be highly sensitive. However, hue was not highly sensitive.

Keywords: Dust artifact, HLS color space, Retinal hemorrhage, and Diabetic retinopathy

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Authors: P. Pongsumpun

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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.

Keywords: Transmission model, intrinsic incubation period, extrinsic incubation period, basic reproductive number, equilibriumstates, local stability.

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Authors: Mecheri Zeid Belmecheri, Maamar Ahfir, Izzet Kale

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Automatic cardiac auscultation is still a subject of research in order to establish an objective diagnosis. Recorded heart sounds as Phonocardiogram (PCG) signals can be used for automatic segmentation into components that have clinical meanings. These are the first sound, S1, the second sound, S2, and the systolic and diastolic components, respectively. In this paper, an automatic method is proposed for the robust segmentation of heart sounds. This method is based on calculating an intermediate sawtooth-shaped signal from the length variation of the recorded PCG signal in the time domain and, using its positive derivative function that is a binary signal in training a Recurrent Neural Network (RNN). Results obtained in the context of a large database of recorded PCGs with their simultaneously recorded Electrocardiograms (ECGs) from different patients in clinical settings, including normal and abnormal subjects, show on average a segmentation testing performance average of 76% sensitivity and 94% specificity.

Keywords: Heart sounds, PCG segmentation, event detection, Recurrent Neural Networks, PCG curve length.

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Authors: Muhammad Zeeshan UlHaque, Peng Du, Leo K. Cheng, Marc D. Jacobs

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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.

Keywords: Diabetic neuropathy, Finite element modeling, Monte Carlo Algorithm, Somatosensory nerve networks

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Authors: M. Ovinis, D. Kerr, K. Bouazza-Marouf, M. Vloeberghs

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The use of anatomical landmarks as a basis for image to patient registration is appealing because the registration may be performed retrospectively. We have previously proposed the use of two anatomical soft tissue landmarks of the head, the canthus (corner of the eye) and the tragus (a small, pointed, cartilaginous flap of the ear), as a registration basis for an automated CT image to patient registration system, and described their localization in patient space using close range photogrammetry. In this paper, the automatic localization of these landmarks in CT images, based on their curvature saliency and using a rule based system that incorporates prior knowledge of their characteristics, is described. Existing approaches to landmark localization in CT images are predominantly semi-automatic and primarily for localizing internal landmarks. To validate our approach, the positions of the landmarks localized automatically and manually in near isotropic CT images of 102 patients were compared. The average difference was 1.2mm (std = 0.9mm, max = 4.5mm) for the medial canthus and 0.8mm (std = 0.6mm, max = 2.6mm) for the tragus. The medial canthus and tragus can be automatically localized in CT images, with performance comparable to manual localization, based on the approach presented.

Keywords: Anatomical Landmarks, CT, Localization.

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Authors: S. Sudhakar, Geetha Manjunath, Siva Teja Kakileti, Himanshu Madhu

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Diagnosis of breast cancer at early stages has seen better clinical and survival outcomes. Survival rates in developing countries like India are very low due to accessibility and affordability issues of screening tests such as Mammography. In addition, Mammography is not much effective in younger women with dense breasts. This leaves a gap in current screening methods. Thermalytix is a new technique for detecting breast abnormality in a non-contact, non-invasive way. It is an AI-enabled computer-aided diagnosis solution that automates interpretation of high resolution thermal images and identifies potential malignant lesions. The solution is low cost, easy to use, portable and is effective in all age groups.  This paper presents the results of a retrospective comparative analysis of Thermalytix over Mammography and Clinical Breast Examination for breast cancer screening. Thermalytix was found to have better sensitivity than both the tests, with good specificity as well. In addition, Thermalytix identified all malignant patients without palpable lumps.

Keywords: Breast Cancer Screening, Radiology, Thermalytix, Artificial Intelligence, Thermography.

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Authors: Chakkrit Snae, Michael Brueckner

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In this paper the authors present the framework of a system for assisting users through counseling on personal health, the Personal Health Assistance Service Expert System (PHASES). Personal health assistance systems need Personal Health Records (PHR), which support wellness activities, improve the understanding of personal health issues, enable access to data from providers of health services, strengthen health promotion, and in the end improve the health of the population. This is especially important in societies where the health costs increase at a higher rate than the overall economy. The most important elements of a healthy lifestyle are related to food (such as balanced nutrition and diets), activities for body fitness (such as walking, sports, fitness programs), and other medical treatments (such as massage, prescriptions of drugs). The PHASES framework uses an ontology of food, which includes nutritional facts, an expert system keeping track of personal health data that are matched with medical treatments, and a comprehensive data transfer between patients and the system.

Keywords: Personal health assistance service, expert system, ontologies, knowledge management, information technology.

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Authors: Irfan Z. Qureshi, Fareeha A., Wajid A. Khan

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Human amniotic membrane (HAM) is a useful biological material for the reconstruction of damaged ocular surface. The processing and preservation of HAM is critical to prevent the patients undergoing amniotic membrane transplant (AMT) from cross infections. For HAM preparation human placenta is obtained after an elective cesarean delivery. Before collection, the donor is screened for seronegativity of HCV, Hbs Ag, HIV and Syphilis. After collection, placenta is washed in balanced salt solution (BSS) in sterile environment. Amniotic membrane is then separated from the placenta as well as chorion while keeping the preparation in BSS. Scrapping of HAM is then carried out manually until all the debris is removed and clear transparent membrane is acquired. Nitrocellulose membrane filters are then placed on the stromal side of HAM, cut around the edges with little membrane folded towards other side making it easy to separate during surgery. HAM is finally stored in solution of glycerine and Dulbecco-s Modified Eagle Medium (DMEM) in 1:1 ratio containing antibiotics. The capped borosil vials containing HAM are kept at -80°C until use. This vial is thawed to room temperature and opened under sterile operation theatre conditions at the time of surgery.

Keywords: HAM, AMT, ocular transplant

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Authors: Tahvilian R., Siahi Shadbad MR., Hamishehkar H., Aghababa Gharehbagh V.

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Nowadays pharmaceutical care departments located in hospitals are amongst the important pillars of the healthcare system. The aim of this study was to evaluate quality of hospital drugstores affiliated with Kermanshah University of Medical Sciences. In this cross-sectional study a validated questionnaire was used. The questionnaire was filled in by the one of the researchers in all seventeen hospital drugstores located in the teaching and nonteaching hospitals affiliated with Kermanshah University of Medical Sciences. The results shows that in observed hospitals,24% of pharmacy environments, 25% of pharmacy store and storage conditions, 49% of storage procedure, 25% of ordering drugs and supplies, 73% of receiving supplies (proper procedure are fallowed for receiving supplies), 35% of receiving supplies (prompt action taken if deterioration of drugs received is suspected), 23.35% of drugs delivery to patients and finally 0% of stock cards are used for proper inventory control have full compliance with standards.

Keywords: Hospital pharmacy standards, Kermanshah, pharmacy management

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Authors: Helena Costa Oliveira, Carmem Oliveira, Rita Moutinho

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The Balanced Scorecard (BSC) is a continuous strategic monitoring model focused not only on financial issues but also on internal processes, patients/users, and learning and growth. Initially dedicated to business management, it currently serves organizations of other natures - such as hospitals. This paper presents a BSC designed for a Portuguese Acute Pain Unit (APU). This study is qualitative and based on the experience of collaborators at the APU. The management of APU is based on four perspectives – users, internal processes, learning and growth, and financial and legal. For each perspective, there were identified strategic objectives, critical factors, lead indicators and initiatives. The strategic map of the APU outlining sustained strategic relations among strategic objectives. This study contributes to the development of research in the health management area as it explores how organizational insufficiencies and inconsistencies in this particular case can be addressed, through the identification of critical factors, to clearly establish core outcomes and initiatives to set up.

Keywords: Acute pain unit, balanced scorecard, hospital management, organizational performance, Portugal.

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Authors: S. Kurien, S. Satpathy, S. K. Gupta, S. K. Arya, D. K. Sharma

Abstract:

Advances in the use of health care technology have resulted in increased adverse events (AEs) related to the use of medical devices. The study focused on the existing reporting systems. This study was conducted in a tertiary care public sector hospital. Devices included Syringe infusion pumps, Cardiac monitors, Pulse oximeters, Ventilators and Defibrillators. A total of 211 respondents were recruited. Interviews were held with 30 key informants. Medical records were scrutinized. Relevant statistical tests were used. Resident doctors reported maximum frequency of AEs, followed by nurses; and least by consultants. A significant association was found between the cadre of health care personnel and awareness that the patients and bystanders have a risk of sustaining AE. Awareness regarding reporting of AEs was low, and it was generally done verbally. Other critical findings are discussed in the light of the barriers to reporting, reasons for non-compliance, recording system, and so on.

Keywords: Adverse events, health care technology, public sector hospital, reporting systems.

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Authors: Mukhtar H. Hassan, Muhammed A. Basher, Elhadi E. Saad, Almahdi M. Almahdi

Abstract:

The aim of this study was to demonstrate the possible effect of some variables such as age, gender, blood sugar level, and duration of diabetes on the serum level of zinc in diabetic individuals from Murzuk area. Serum zinc (Zn), Fasting blood sugar (FBS), hemoglobin HbA1c (HbA1c) were evaluated in 46 type I diabetic subjects (group 1), 48 type II diabetic subjects (group 2) and 43 healthy individuals (control) of both genders aged (30-81) years. Data showed that both diabetic groups have significantly higher (P<0.05) serum levels of Zn, FBS and HbA1c compared with controls. No significant (p>0.05) differences in serum Zn levels were observed between Males and Females. Serum Zn levels were non-significantly decreased with increasing age. In type II diabetic subjects, serum Zn levels were non-significantly decreased with increasing duration of disease whereas those in type I were non-significantly increased.

Keywords: Blood sugar, diabetes, HbA1c, zinc.

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