Search results for: Medical Surgical

Authors: Hsiu-Yuan Wang, Shwu-Huey Wang

Abstract:

This study proposes and tests a rescapturing elements of perceived gain and loss that, by perceived value of medical tourism products, influencintention of potential customers. Data from 301 usable qwere tested against the research model using the structmodeling approach. The results indicated that perceivedkey predictor of customer intentions. As for benefimedical quality, service quality and enjoyment wcomponents that significantly influenced the perceptiRegarding sacrifice, the effects of perceived risk on pewere significant. The findings can provide insights intohow destination countries can make medical tourism a wfor themselves and international patients.KeywordsMedical tourism, perceived valueintention.

Keywords: Medical tourism, perceived valueintention.

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Authors: Samia Boucherkha, Mohamed Benmohamed

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In this paper we investigate the watermarking authentication when applied to medical imagery field. We first give an overview of watermarking technology by paying attention to fragile watermarking since it is the usual scheme for authentication.We then analyze the requirements for image authentication and integrity in medical imagery, and we show finally that invertible schemes are the best suited for this particular field. A well known authentication method is studied. This technique is then adapted here for interleaving patient information and message authentication code with medical images in a reversible manner, that is using lossless compression. The resulting scheme enables on a side the exact recovery of the original image that can be unambiguously authenticated, and on the other side, the patient information to be saved or transmitted in a confidential way. To ensure greater security the patient information is encrypted before being embedded into images.

Keywords: Medical Imaging, Invertible Watermarking, Authentication, Integrity.

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Authors: Zeynep Sener, Mehtap Dursun

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Supplier evaluation and selection is one of the most important components of an effective supply chain management system. Due to the expanding competition in healthcare, selecting the right medical device suppliers offers great potential for increasing quality while decreasing costs. This paper proposes a fuzzy decision making approach for medical supplier selection. A real-world medical device supplier selection problem is presented to illustrate the application of the proposed decision methodology.

Keywords: Fuzzy decision making, fuzzy multiple objective programming, medical supply chain, supplier selection.

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Authors: Abdel-Badeeh M. Salem

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Case based reasoning (CBR) methodology presents a foundation for a new technology of building intelligent computeraided diagnoses systems. This Technology directly addresses the problems found in the traditional Artificial Intelligence (AI) techniques, e.g. the problems of knowledge acquisition, remembering, robust and maintenance. This paper discusses the CBR methodology, the research issues and technical aspects of implementing intelligent medical diagnoses systems. Successful applications in cancer and heart diseases developed by Medical Informatics Research Group at Ain Shams University are also discussed.

Keywords: Medical Informatics, Computer-Aided MedicalDiagnoses, AI in Medicine, Case-Based Reasoning.

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Authors: Siham Jemal Kedir

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Information communication technology is dramatically transforming the health sector, especially in developing countries with few resources and burgeoning access to an internet connection. As a result, processes such as record keeping, administration, and human resources have been vastly simplified, allowing hospitals to focus on delivering urgent medical care. This paper will explore the impact of IT through a study of the electronic medical record system in the Mekelle City Health Center in Tigray Region, Ethiopia. This paper has four specific objectives: 1. developing artifacts in the Electronic Medical Record system, 2. preparing a diagram for step-by-step development of Electronic Medical Records, 3. creating a draft website with the proposed Electronic Medical Record system, and 4. Testing and evaluating the performance and user acceptance of the system. The research will be done in a qualitative manner employing interviews and in-person observation. The research has found the following major results: firstly, the medical record system has been difficult to implement. Second, the Mekelle Health Center is using a manual recording system which is time-consuming and inefficient. The old recording system in the Center leads to the dissatisfaction of patients as well as the service provider staff. As a result, to transform the manual recording system into a digital system, an electronic medical recording system has been developed. The developed system has been tested for implementation and has been successful. Consequently, the administrator of the health center is ready to implement and use the developed software to introduce a medical recording system in Mekelle Health Center.

Keywords: Electronic Health Record Implementation, EMR System Development, Medical Record.

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Authors: Mayssa Bensalah, Atef Boujelben, Mouna Baklouti, Mohamed Abid

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Image segmentation has a fundamental role in analysis and interpretation for many applications. The automated segmentation of organs and tissues throughout the body using computed imaging has been rapidly increasing. Indeed, it represents one of the most important parts of clinical diagnostic tools. In this paper, we discuss a thorough literature review of recent methods of tumour segmentation from medical images which are briefly explained with the recent contribution of various researchers. This study was followed by comparing these methods in order to define new directions to develop and improve the performance of the segmentation of the tumour area from medical images.

Keywords: Features extraction, image segmentation, medical images, tumour detection.

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Authors: Wanda Luen-Wun Siu, Xiaowen Zhang

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The outbreak of COVID-19 epidemic has caused great difficulties for South-South cooperation, but there are also opportunities. China’s health diplomacy has changed from dispatching medical teams, assisting in the construction of hospitals, and to encouraging medical investment in the Africa health sector. This paper adopted a retrospective review of China’s health statecraft in Africa from 1963 to 2020. Findings suggested that China has a preference for aiding Africa health infrastructure and sending medical teams to African countries and it is both socially and financially sustainable. China’s health diplomacy in Africa is a success and has established secure diplomatic relations with African countries, thanks to the medical and health assistance to Africa over 60 years. This research contributes to the literature of health diplomacy and indicates that China’s health aid has fostered cooperation at the medical and diplomatic levels.

Keywords: Africa, bilateral relations, China’s Health Diplomacy, COVID-19.

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Authors: Sung Ho Ha, Seong Hyeon Joo

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Data mining techniques have been used in medical research for many years and have been known to be effective. In order to solve such problems as long-waiting time, congestion, and delayed patient care, faced by emergency departments, this study concentrates on building a hybrid methodology, combining data mining techniques such as association rules and classification trees. The methodology is applied to real-world emergency data collected from a hospital and is evaluated by comparing with other techniques. The methodology is expected to help physicians to make a faster and more accurate classification of chest pain diseases.

Keywords: Data mining, medical decisions, medical domainknowledge, chest pain.

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Authors: P. S. Gomathi, B. Kalaavathi

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The process in which the complementary information from multiple images is integrated to provide composite image that contains more information than the original input images is called image fusion. Medical image fusion provides useful information from multimodality medical images that provides additional information to the doctor for diagnosis of diseases in a better way. This paper represents the wavelet based medical image fusion algorithm on different multimodality medical images. In order to fuse the medical images, images are decomposed using Redundant Wavelet Transform (RWT). The high frequency coefficients are convolved with morphological operator followed by the maximum-selection (MS) rule. The low frequency coefficients are processed by MS rule. The reconstructed image is obtained by inverse RWT. The quantitative measures which includes Mean, Standard Deviation, Average Gradient, Spatial frequency, Edge based Similarity Measures are considered for evaluating the fused images. The performance of this proposed method is compared with Pixel averaging, PCA, and DWT fusion methods. When compared with conventional methods, the proposed framework provides better performance for analysis of multimodality medical images.

Keywords: Discrete Wavelet Transform (DWT), Image Fusion, Morphological Processing, Redundant Wavelet Transform (RWT).

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Authors: Aryana Collins Jackson, Elisabetta Bevacqua, Pierre De Loor, Ronan Querrec

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This paper presents a taxonomy of non-technical skills, communicative intentions, and behavior for an individual acting as a medical coordinator. In medical emergency situations, a leader among the group is imperative to both patient health and team emotional and mental health. Situational Leadership is used to make clear and easy-to-follow guidelines for behavior depending on circumstantial factors. Low-level leadership behaviors belonging to two different styles, directive and supporting, are identified from literature and are included in the proposed taxonomy. The high-level information in the taxonomy consists of the necessary non-technical skills belonging to a medical coordinator: situation awareness, decision making, task management, and teamwork. Finally, communicative intentions, dimensions, and functions are included. Thus this work brings high-level and low-level information - medical non-technical skills, communication capabilities, and leadership behavior - into a single versatile taxonomy of behavior.

Keywords: Medical, leadership styles, taxonomy, human behavior.

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Authors: Fahad Shahbaz Khan, Fahad Maqbool, Saad Razzaq, Kashif Irfan, Tehseen Zia

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Expert systems are used extensively in many domains. This paper discusses the use of medical expert systems in Pakistan. Countries all over the world pay special attention on health facilities. A country like Pakistan faces a lot of trouble in health sector. Several attempts have been made in Pakistan to improve the health conditions of the people but the situation is still not encouraging. There is a shortage of doctors and other trained personnel in Pakistan. Expert systems can play a vital role in such cases where the medical expert is not readily available. The purpose of this paper is to analyze the role that such systems can play in improving the health conditions of the people in Pakistan.

Keywords: Medical Diagnostics, Expert Systems, Pakistan.

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Authors: Puteri Nemie Jahn Kassim, Khadijah Mohd Najid

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Medical negligence disputes in Malaysia are mainly resolved through litigation by using the tort system. The tort system, being adversarial in nature has subjected parties to litigation hazards such as delay, excessive costs and uncertainty of outcome. The dissatisfaction of the tort system in compensating medically injured victims has created various alternatives to litigation. Amongst them is the implementation of a no-fault compensation system which would allow compensation to be given without the need of proving fault on the medical personnel. Instead, the community now bears the burden of compensating and at the end, promotes collective responsibility. For Malaysia, introducing a no-fault system would provide a tempting solution and may ultimately, achieve justice for the medical injured victims. Nevertheless, such drastic change requires a great deal of consideration to determine the suitability of the system and whether or not it will eventually cater for the needs of the Malaysian population

Keywords: Medical Disputes, Litigation, Malaysia, No-Fault Compensation.

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Authors: Lara Dutil-Fafard, Caroline Rhéaume, Patrick Archambault, Daniel Lafond, Neal W. Pollock

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Improving resources for medical autonomy of astronauts in prolonged space missions, such as a Mars mission, requires not only technology development, but also decision-making support systems. The Advanced Crew Medical System - Medical Condition Requirements study, funded by the Canadian Space Agency, aimed to create knowledge content and a scenario-based query capability to support medical autonomy of astronauts. The key objective of this study was to create a prototype tool for identifying medical infrastructure requirements in terms of medical knowledge, skills and materials. A multicriteria decision-making method was used to prioritize the highest risk medical events anticipated in a long-term space mission. Starting with those medical conditions, event sequence diagrams (ESDs) were created in the form of decision trees where the entry point is the diagnosis and the end points are the predicted outcomes (full recovery, partial recovery, or death/severe incapacitation). The ESD formalism was adapted to characterize and compare possible outcomes of medical conditions as a function of available medical knowledge, skills, and supplies in a given mission scenario. An extensive literature review was performed and summarized in a medical condition database. A PostgreSQL relational database was created to allow query-based evaluation of health outcome metrics with different medical infrastructure scenarios. Critical decision points, skill and medical supply requirements, and probable health outcomes were compared across chosen scenarios. The three medical conditions with the highest risk rank were acute coronary syndrome, sepsis, and stroke. Our efforts demonstrate the utility of this approach and provide insight into the effort required to develop appropriate content for the range of medical conditions that may arise.

Keywords: Decision support system, event sequence diagram, exploration mission, medical autonomy, scenario-based queries, space medicine.

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Authors: A. Rubiano F, N. Olarte, D. Lara

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This paper presents the design, implementation and results related to the storage system of medical information associated to the ECG (Electrocardiography) signal. The system includes the signal acquisition modules, the preprocessing and signal processing, followed by a module of transmission and reception of the signal, along with the storage and web display system of the medical platform. The tests were initially performed with this signal, with the purpose to include more biosignal under the same system in the future.

Keywords: Acquisition, ECG Signal, Storage, Web Platform

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Authors: Aki Sugano, Mika Ohta, Mineko Ikegami, Kenji Miura, Sayo Tsukamoto, Akihiro Ichinose, Toshiko Ohshima, Eiichi Maeda, Masako Matsuura, Yutaka Takao

Abstract:

Along with the advances in medicine, providing medical information to individual patient is becoming more important. In Japan such information via Braille is hardly provided to blind and partially sighted people. Thus we are researching and developing a Web-based automatic translation program “eBraille" to translate Japanese text into Japanese Braille. First we analyzed the Japanese transcription rules to implement them on our program. We then added medical words to the dictionary of the program to improve its translation accuracy for medical text. Finally we examined the efficacy of statistical learning models (SLMs) for further increase of word segmentation accuracy in braille translation. As a result, eBraille had the highest translation accuracy in the comparison with other translation programs, improved the accuracy for medical text and is utilized to make hospital brochures in braille for outpatients and inpatients.

Keywords: Automatic Braille translation, Medical text, Partially sighted people.

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Authors: Ismail Baniadam, Nafisa Tadayyon, Javid Fereidoni

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This study aimed to investigate medical students’ attitudes toward some teachers’ talking features regarding their gender in the Iranian context. To do so, 60 male and 60 female medical students of Urmia University of Medical Sciences (UMSU) participated in the research. A researcher made Likert-type questionnaire which was initially piloted and was used to gather the data. Comparing the four different factors regarding the features of teacher talk, it was revealed that visual and extra-linguistic information factor, Lexical and syntactic familiarity, Speed of speech, and the use of Persian language had the highest to the lowest mean score, respectively. It was also indicated that female students rather than male students were significantly more in favor of speed of speech and lexical and syntactic familiarity.

Keywords: Attitude, gender, medical student, teacher talk.

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Authors: Mai Miyabe, Taku Fukushima, Takashi Yoshino, Aguri Shigeno

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The need for multilingual communication in Japan has increased due to an increase in the number of foreigners in the country. When people communicate in their nonnative language, the differences in language prevent mutual understanding among the communicating individuals. In the medical field, communication between the hospital staff and patients is a serious problem. Currently, medical translators accompany patients to medical care facilities, and the demand for medical translators is increasing. However, medical translators cannot necessarily provide support, especially in cases in which round-the-clock support is required or in case of emergencies. The medical field has high expectations from information technology. Hence, a system that supports accurate multilingual communication is required. Despite recent advances in machine translation technology, it is very difficult to obtain highly accurate translations. We have developed a support system called M3 for multilingual medical reception. M3 provides support functions that aid foreign patients in the following respects: conversation, questionnaires, reception procedures, and hospital navigation; it also has a Q&A function. Users can operate M3 using a touch screen and receive text-based support. In addition, M3 uses accurate translation tools called parallel texts to facilitate reliable communication through conversations between the hospital staff and the patients. However, if there is no parallel text that expresses what users want to communicate, the users cannot communicate. In this study, we have developed a circulating support environment for multilingual medical communication using parallel texts. The proposed environment can circulate necessary parallel texts through the following procedure: (1) a user provides feedback about the necessary parallel texts, following which (2) these parallel texts are created and evaluated.

Keywords: multilingual medical communication, parallel texts.

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Authors: Trevor Kroeger, Hayden Williams, Edward Holzinger, David Coleman, Brian Haberman

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The network connectivity of medical devices is increasing at a rapid rate. Many medical devices, such as vital sign monitors, share information via wireless or wired connections. However, these connectivity options suffer from a variety of well-known limitations. Wireless connectivity, especially in the unlicensed radio frequency bands, can be disrupted. Such disruption could be due to benign reasons, such as a crowded spectrum, or to malicious intent. While wired connections are less susceptible to interference, they inhibit the mobility of the medical devices, which could be critical in a variety of scenarios. This work explores the application of Light Fidelity (Li-Fi) communication to enhance the security, performance, and mobility of medical devices in connected healthcare scenarios. A simple bridge for connected devices serves as an avenue to connect traditional medical devices to the Li-Fi network. This bridge was utilized to conduct bandwidth tests on a small Li-Fi network installed into a Mock-ICU setting with a backend enterprise network similar to that of a hospital. Mobile and stationary tests were conducted to replicate various different situations that might occur within a hospital setting. Results show that in room Li-Fi connectivity provides reasonable bandwidth and latency within a hospital like setting.

Keywords: Hospital, light fidelity, Li-Fi, medical devices, security.

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Authors: W. Maddison

Abstract:

This paper describes an Action Research project which was undertaken to inform professional practice in order to develop a newly created Centre for Student Success in the specific context of transnational medical and nursing education in the Middle East. The objectives were to enhance the academic performance, persistence, integration and personal and professional development of a multinational study body, in particular in relation to pre-clinical medical students, and to establish a comfortable, friendly and student-driven environment within an Irish medical university recently established in Bahrain. The outcomes of the project resulted in the development of a specific student success ‘signature’ for this particular transnational higher education context.

Keywords: Global-Local, pre-clinical medical students, student success, transnational higher education, Middle East.

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Authors: Y. N. Phang, E. F. Loh

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Many researchers have suggested the use of zero inflated Poisson (ZIP) and zero inflated negative binomial (ZINB) models in modeling overdispersed medical count data with extra variations caused by extra zeros and unobserved heterogeneity. The studies indicate that ZIP and ZINB always provide better fit than using the normal Poisson and negative binomial models in modeling overdispersed medical count data. In this study, we proposed the use of Zero Inflated Inverse Trinomial (ZIIT), Zero Inflated Poisson Inverse Gaussian (ZIPIG) and zero inflated strict arcsine models in modeling overdispered medical count data. These proposed models are not widely used by many researchers especially in the medical field. The results show that these three suggested models can serve as alternative models in modeling overdispersed medical count data. This is supported by the application of these suggested models to a real life medical data set. Inverse trinomial, Poisson inverse Gaussian and strict arcsine are discrete distributions with cubic variance function of mean. Therefore, ZIIT, ZIPIG and ZISA are able to accommodate data with excess zeros and very heavy tailed. They are recommended to be used in modeling overdispersed medical count data when ZIP and ZINB are inadequate.

Keywords: Zero inflated, inverse trinomial distribution, Poisson inverse Gaussian distribution, strict arcsine distribution, Pearson’s goodness of fit.

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Authors: Cristina M. R. Caridade, Ana Rita F. Morais

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The use of computational tools has become essential in the context of interactive learning, especially in engineering education. In the medical industry, teaching medical image processing techniques is a crucial part of training biomedical engineers, as it has integrated applications with health care facilities and hospitals. The aim of this article is to present a teaching-learning simulation tool, developed in MATLAB using Graphical User Interface, for medical image fusion that explores different image fusion methodologies and processes in combination with image pre-processing techniques. The application uses different algorithms and medical fusion techniques in real time, allowing to view original images and fusion images, compare processed and original images, adjust parameters and save images. The tool proposed in an innovative teaching and learning environment, consists of a dynamic and motivating teaching simulation for biomedical engineering students to acquire knowledge about medical image fusion techniques, necessary skills for the training of biomedical engineers. In conclusion, the developed simulation tool provides a real-time visualization of the original and fusion images and the possibility to test, evaluate and progress the student’s knowledge about the fusion of medical images. It also facilitates the exploration of medical imaging applications, specifically image fusion, which is critical in the medical industry. Teachers and students can make adjustments and/or create new functions, making the simulation environment adaptable to new techniques and methodologies.

Keywords: Image fusion, image processing, teaching-learning simulation tool, biomedical engineering education.

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Authors: Nisar Ahmed Memon, Anwar Majid Mirza, S.A.M. Gilani

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Segmentation is an important step in medical image analysis and classification for radiological evaluation or computer aided diagnosis. This paper presents the problem of inaccurate lung segmentation as observed in algorithms presented by researchers working in the area of medical image analysis. The different lung segmentation techniques have been tested using the dataset of 19 patients consisting of a total of 917 images. We obtained datasets of 11 patients from Ackron University, USA and of 8 patients from AGA Khan Medical University, Pakistan. After testing the algorithms against datasets, the deficiencies of each algorithm have been highlighted.

Keywords: Computer Aided Diagnosis (CAD), MathematicalMorphology, Medical Image Analysis, Region Growing, Segmentation, Thresholding,

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Authors: Jagadish H. Pujar, Pallavi S. Gurjal, Shambhavi D. S, Kiran S. Kunnur

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Medical image segmentation based on image smoothing followed by edge detection assumes a great degree of importance in the field of Image Processing. In this regard, this paper proposes a novel algorithm for medical image segmentation based on vigorous smoothening by identifying the type of noise and edge diction ideology which seems to be a boom in medical image diagnosis. The main objective of this algorithm is to consider a particular medical image as input and make the preprocessing to remove the noise content by employing suitable filter after identifying the type of noise and finally carrying out edge detection for image segmentation. The algorithm consists of three parts. First, identifying the type of noise present in the medical image as additive, multiplicative or impulsive by analysis of local histograms and denoising it by employing Median, Gaussian or Frost filter. Second, edge detection of the filtered medical image is carried out using Canny edge detection technique. And third part is about the segmentation of edge detected medical image by the method of Normalized Cut Eigen Vectors. The method is validated through experiments on real images. The proposed algorithm has been simulated on MATLAB platform. The results obtained by the simulation shows that the proposed algorithm is very effective which can deal with low quality or marginal vague images which has high spatial redundancy, low contrast and biggish noise, and has a potential of certain practical use of medical image diagnosis.

Keywords: Image Segmentation, Image smoothing, Edge Detection, Impulsive noise, Gaussian noise, Median filter, Canny edge, Eigen values, Eigen vector.

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Authors: Peter U. Eze, P. Udaya, Robin J. Evans

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Data hiding can be achieved by Steganography or invisible digital watermarking. For digital watermarking, both accurate retrieval of the embedded watermark and the integrity of the cover image are important. Medical image security in Teleradiology is one of the applications where the embedded patient record needs to be extracted with accuracy as well as the medical image integrity verified. In this research paper, the Constant Correlation Spread Spectrum digital watermarking for medical image tamper detection and accurate embedded watermark retrieval is introduced. In the proposed method, a watermark bit from a patient record is spread in a medical image sub-block such that the correlation of all watermarked sub-blocks with a spreading code, W, would have a constant value, p. The constant correlation p, spreading code, W and the size of the sub-blocks constitute the secret key. Tamper detection is achieved by flagging any sub-block whose correlation value deviates by more than a small value, ℇ, from p. The major features of our new scheme include: (1) Improving watermark detection accuracy for high-pixel depth medical images by reducing the Bit Error Rate (BER) to Zero and (2) block-level tamper detection in a single computational process with simultaneous watermark detection, thereby increasing utility with the same computational cost.

Keywords: Constant correlation, medical image, spread spectrum, tamper detection, watermarking.

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Authors: Md Shohidul Islam, Jongmyon Kim, Ui-pil Chong

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Medical image is an integral part of e-health care and e-diagnosis system. Medical image watermarking is widely used to protect patients’ information from malicious alteration and manipulation. The watermarked medical images are transmitted over the internet among patients, primary and referred physicians. The images are highly prone to corruption in the wireless transmission medium due to various noises, deflection, and refractions. Distortion in the received images leads to faulty watermark detection and inappropriate disease diagnosis. To address the issue, this paper utilizes error correction code (ECC) with (8, 4) Hamming code in an existing watermarking system. In addition, we implement the high complex ECC on a graphics processing units (GPU) to accelerate and support real-time requirement. Experimental results show that GPU achieves considerable speedup over the sequential CPU implementation, while maintaining 100% ECC efficiency.

Keywords: Medical Image Watermarking (MIW), e-health system, error correction, Hamming code, GPU.

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Authors: Nahla Ibraheem Jabbar, Monica Mehrotra

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This paper used a fuzzy kohonen neural network for medical image segmentation. Image segmentation plays a important role in the many of medical imaging applications by automating or facilitating the diagnostic. The paper analyses the tumor by extraction of the features of (area, entropy, means and standard deviation).These measurements gives a description for a tumor.

Keywords: FCM, features extraction, medical image processing, neural network, segmentation.

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Authors: Mannan Mridha, Mohammad S. Islam

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Innovative medical technologies offer more effective medical care, with less risk to patient and healthcare personnel. Medical technology and devices when properly used provide better data, precise monitoring and less invasive treatments and can be more targeted and often less costly. The Intensive Care Unit (ICU) equipped with patient monitoring, respiratory and cardiac support, pain management, emergency resuscitation and life support devices is particularly prone to medical errors for various reasons. Many people in the developing countries now wonder whether their visit to hospital might harm rather than help them. This is because; clinicians in the developing countries are required to maintain an increasing workload with limited resources and absence of well-functioning safety system. A team of experts from the medical, biomedical and clinical engineering in Sweden and Bangladesh have worked together to study the incidents, adverse events at the ICU in Bangladesh. The study included both public and private hospitals to provide a better understanding for physical structure, organization and practice in operating processes of care, and the occurrence of adverse outcomes the errors, risks and accidents related to medical devices at the ICU, and to develop a ICT based support system in order to reduce hazards and errors and thus improve the quality of performance, care and cost effectiveness at the ICU. Concrete recommendations and guidelines have been made for preparing appropriate ICT related tools and methods for improving the routine for use of medical devices, reporting and analyzing of the incidents at the ICU in order to reduce the number of undetected and unsolved incidents and thus improve the patient safety.

Keywords: Accidents reporting system, patient car and safety, safe medical devices.

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Authors: Chaudhary Itisha, Shankar Manu

Abstract:

Patient satisfaction represents a crucial aspect in the evaluation of health care services. Preoperative teaching provides the patient with pertinent information concerning the surgical process and the intended surgical procedure as well as anticipated patient behavior (anxiety, fear), expected sensation, and the probable outcomes. Although patient education is part of Accreditation protocols, it is not uniform at most places. The aim of this study was to try to assess the benefit of preoperative patient education on selected post-operative outcome parameters; mainly, post-operative pain scores, requirement of additional analgesia, return to activity of daily living and overall patient satisfaction, and try to standardize few education protocols. Dependent variables were measured before and after the treatment on a study population of 302 volunteers. Educational intervention was provided by the Investigator in the preoperative period to the study group through personal counseling. An information booklet contained detailed information was also provided. Statistical Analysis was done using Chi square test, Mann Whitney u test and Fischer Exact Test on a total of 302 subjects. P value <0.05 was considered as level of statistical significance and p<0.01 was considered as highly significant. This study suggested that patients who are given a structured, individualized and elaborate preoperative education and counseling have a better ability to cope up with postoperative pain in the immediate post-operative period. However, there was not much difference when the patients have had almost complete recovery. There was no difference in the requirement of additional analgesia among the two groups. There is a positive effect of preoperative counseling on expected return to the activities of daily living and normal work schedule. However, no effect was observed on the activities in the immediate post-operative period. There is no difference in the overall satisfaction score among the two groups of patients. Thus this study concludes that there is a positive benefit as suggested by the results for pre-operative patient education. Although the difference in various parameters studied might not be significant over a long term basis, they definitely point towards the benefits of preoperative patient education. 

Keywords: Patient education, post-operative pain, patient satisfaction, post-operative outcome.

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Authors: J. Mehena, M. C. Adhikary

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In this paper, a spatial multiple-kernel fuzzy C-means (SMKFCM) algorithm is introduced for segmentation problem. A linear combination of multiples kernels with spatial information is used in the kernel FCM (KFCM) and the updating rules for the linear coefficients of the composite kernels are derived as well. Fuzzy cmeans (FCM) based techniques have been widely used in medical image segmentation problem due to their simplicity and fast convergence. The proposed SMKFCM algorithm provides us a new flexible vehicle to fuse different pixel information in medical image segmentation and detection of MR images. To evaluate the robustness of the proposed segmentation algorithm in noisy environment, we add noise in medical brain tumor MR images and calculated the success rate and segmentation accuracy. From the experimental results it is clear that the proposed algorithm has better performance than those of other FCM based techniques for noisy medical MR images.

Keywords: Clustering, fuzzy C-means, image segmentation, MR images, multiple kernels.

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Authors: B. Stroetmann, A. Aisenbrey

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The Siemens Healthcare Sector is one of the world's largest suppliers to the healthcare industry and a trendsetter in medical imaging and therapy, laboratory diagnostics, medical information technology, and hearing aids. Siemens offers its customers products and solutions for the entire range of patient care from a single source – from prevention and early detection to diagnosis, and on to treatment and aftercare. By optimizing clinical workflows for the most common diseases, Siemens also makes healthcare faster, better, and more cost effective. The optimization of clinical workflows requires a multidisciplinary focus and a collaborative approach of e.g. medical advisors, researchers and scientists as well as healthcare economists. This new form of collaboration brings together experts with deep technical experience, physicians with specialized medical knowledge as well as people with comprehensive knowledge about health economics. As Charles Darwin is often quoted as saying, “It is neither the strongest of the species that survive, nor the most intelligent, but the one most responsive to change," We believe that those who can successfully manage this change will emerge as winners, with valuable competitive advantage. Current medical information and knowledge are some of the core assets in the healthcare industry. The main issue is to connect knowledge holders and knowledge recipients from various disciplines efficiently in order to spread and distribute knowledge.

Keywords: Business Excellence, Clinical Knowledge, Knowledge Management, Knowledge Services, Learning Organizations, Trust.

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