Search results for: medical disputes

Authors: Manal Rauf

Abstract:

Trained medical practitioners are produced from medical colleges serving in public and private sectors. Prime responsibility of teaching faculty is to inculcate required work ethic among the students by serving as role models for them. It is an observed fact that classroom incivility behaviours are providing a friction in achieving these targets. Present study aimed at identification of classroom incivility behaviours observed by teachers and students of public and private medical colleges as per Glasser’s Choice Theory, making a comparison and investigating the strategies being adopted by teachers of both sectors to control undesired class room behaviours. Findings revealed that a significant difference occurs between teacher and student incivility behaviours. Public sector teacher focussed on survival as a strong factor behind in civil behaviours whereas private sector teachers considered power as the precedent for incivility. Teachers of both sectors are required to use verbal as well as non-verbal immediacy to reach a healthy leaning environment.

Keywords: Classroom incivility behaviour, Glasser choice theory, Mehrabian immediacy theory, medical student.

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Authors: Rita C. Ramos

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Medical Surgical Nursing is one of the major subjects in nursing. This study examined the validity and reliability of the achievement examination utilizing the Classical Test Theory and Item Response Theory. The study answered the following objectives specifically : ( a) To establish the validity and reliability of the achievement examination utilizing Classical Test Theory and Item Response Theory ; ( b ) To determine the dimensionality measure of items and ( c ) to compare the item difficulty and item discrimination of the Medical Surgical Nursing Achievement examination using Classical Test Theory ( CTT ) and Item Response Theory ( IRT ). The developed instrument was administered to fourth year nursing students (N= 136) of a private university in Manila. The findings yielded the following results: The achievement examination is reliable both using CTT and IRT. The findings indicate person and item statistics from two frameworks are quite alike. The achievement examination formed a unidimensional construct.

Keywords: Achievement Examination, Item Response Theory, Medical Surgical, Nursing.

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Authors: M. Das Gupta, S. Banerjee

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Content Based Image Retrieval (CBIR) coupled with Case Based Reasoning (CBR) is a paradigm that is becoming increasingly popular in the diagnosis and therapy planning of medical ailments utilizing the digital content of medical images. This paper presents a survey of some of the promising approaches used in the detection of abnormalities in retina images as well in mammographic screening and detection of regions of interest in MRI scans of the brain. We also describe our proposed algorithm to detect hard exudates in fundus images of the retina of Diabetic Retinopathy patients.

Keywords: Case based reasoning, Exudates, Retina image, Similarity based retrieval.

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Authors: Jenny Paola Forero Pachón, Sonia Cristina Gamboa Sarmiento, Luis Carlos Gómez Flórez

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The Colombian government has defined an e-government strategy to take advantage of Information Technologies (IT) in order to contribute to the building of a more efficient, transparent and participative State that provides better services to citizens and businesses. In this regard, the Justice sector is one of the government sectors where IT has generated more expectation considering that the country has a judicial processes backlog. This situation has led to the search for alternative forms of access to justice that speed up the process while providing a low cost for citizens. To this end, the Colombian government has authorized the use of Alternative Dispute Resolution methods (ADR), a remedy where disputes can be resolved more quickly compared to judicial processes while facilitating greater communication between the parties, without recourse to judicial authority. One of these methods is conciliation, which includes a special modality that takes advantage of IT for the development of itself known as virtual conciliation. With this option the conciliation is supported by information systems, applications or platforms and communications are provided through it. This paper evaluates the level of maturity in how the service of virtual conciliation is under the framework of this strategy. This evaluation is carried out considering Shahkooh's 5-phase model for e-government. As a result, it is evident that in the context of conciliation, maturity does not reach the necessary level in the model so that it can be considered as virtual conciliation; therefore, it is necessary to define strategies to maximize the potential of IT in this context.

Keywords: Alternative dispute resolution, e-government, evaluation of maturity, Shahkooh model, virtual conciliation.

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Authors: Gurung S., Yadav B. N., Budhathoki SS.

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Problem based learning is one of the highly acclaimed learning methods in medical education since its first introduction at Mc-Master University in Canada in the 1960s. It has now been adopted as a teaching learning method in many medical colleges of Nepal. B.P. Koirala Institute of Health Sciences (BPKIHS), a health science deemed university is the second institute in Nepal to establish problem-based learning academic program and need-based teaching approach hence minimizing teaching through lectures since its inception. During the first two years of MBBS course, the curriculum is divided into various organ-systems incorporated with problem-based learning exercise each of one week duration.

Keywords: PBL, medical education.

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Authors: G. Gürsel, K. H. Gülkesen, N. Zayim, A. Arifoğlu, O. Saka

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User satisfaction is one of the most used success indicators in the research of information system (IS). Literature shows user expectations have great influence on user satisfaction. Both expectation and satisfaction of users are important for Hospital Information Systems (HIS). Education, IS experience, age, attitude towards change, business title, sex and working unit of the hospital, are examined as the potential determinant of the medical users’ expectations. Data about medical user expectations are collected by the “Expectation Questionnaire” developed for this study. Expectation data are used for calculating the Expectation Meeting Ratio (EMR) with the evaluation framework also developed for this study. The internal consistencies of the answers to the questionnaire are measured by Cronbach´s Alpha coefficient. The multivariate analysis of medical user’s EMRs of HIS is performed by forward stepwise binary logistic regression analysis. Education and business title is appeared to be the determinants of expectations from HIS.

Keywords: Evaluation, Fuzzy Logic, Hospital Information System, User Expectation.

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Authors: P. Prudtikul, S. Pathomsiri

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Most, if not all, public hospitals in Thailand have encountered a common problem regarding the increasing demand for medical services. The increasing number of patients causes so much strain on the hospital-s services, over-crowded, overloaded working hours, staff fatigue, medical error and long waiting time. This research studied the characteristics of operational processes of the medical care services at the medicine department in a large public university hospital. The research focuses on details regarding methods, procedures, processes, resources, and time management in overall processes. The simulation model is used as a tool to analyze the impact of various improvement strategies.

Keywords: Patient flow, medicine department, simulation, outpatient department.

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Authors: Cleto J. Sauer Jr

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Introduction: Brazil’s new national curriculum guidelines (NCG) for medical education were published in 2014, presenting active learning methodologies as a cornerstone. Simulation was initially applied for aviation pilots’ training and is currently applied in health sciences. The high-fidelity simulator replicates human body anatomy in detail, also reproducing physiological functions and its use is increasing in medical schools. Realistic Simulation (RS) has pedagogical aspects that are aligned with Brazil’s NCG teaching concepts. The main objective of this study is to carry on a narrative review on RS’s aspects that are aligned with Brazil’s new NCG teaching concepts. Methodology: A narrative review was conducted, with search in three databases (PubMed, Embase and BVS) of studies published between 2010 and 2020. Results: After systematized search, 49 studies were selected and divided into four thematic groups. RS is aligned with new Brazilian medical curriculum as it is an active learning methodology, providing greater patient safety, uniform teaching, and student's emotional skills enhancement. RS is based on reflective learning, a teaching concept developed for adult’s education. Conclusion: RS is a methodology aligned with NCG teaching concepts and has potential to assist in the implementation of new Brazilian medical school’s curriculum. It is an immersive and interactive methodology, which provides reflective learning in a safe environment for students and patients.

Keywords: Curriculum, high-fidelity simulator, medical education, realistic simulation.

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Authors: Y. Y. Su, K. T. Win, H. C. Chiu

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This study used Item Analysis, Exploratory Factor Analysis (EFA) and Reliability Analysis (Cronbach-s α value) to exam the Questions which selected by the Delphi method based on the issue of “Socio-technical system (STS)" and user-centered perspective. A structure questionnaire with seventy-four questions which could be categorized into nine dimensions (healthcare environment, organization behaviour, system quality, medical data quality, service quality, safety quality, user usage, user satisfaction, and organization net benefits) was provided to evaluate EMR of the Taiwanese healthcare environment.

Keywords: Instrument development, Reliability test, Validity test, Electronic Medical Record Evaluation.

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Authors: Siau-Chuin Liew, Siau-Way Liew, Jasni Mohd Zain

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Digital watermarking in medical images can ensure the authenticity and integrity of the image. This design paper reviews some existing watermarking schemes and proposes a reversible tamper detection and recovery watermarking scheme. Watermark data from ROI (Region Of Interest) are stored in RONI (Region Of Non Interest). The embedded watermark allows tampering detection and tampered image recovery. The watermark is also reversible and data compression technique was used to allow higher embedding capacity.

Keywords: data compression, medical image, reversible, tamperdetection and recovery, watermark.

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Authors: Amudha Kadirvelu, Sunil Gurtu, Sivalal Sadasivan

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Pharmacology curriculum plays an integral role in medical education. Learning pharmacology to choose and prescribe drugs is a major challenge encountered by students. We developed pharmacology applied learning activities for first year medical students that included realistic clinical situations with escalating complications which required the students to analyze the situation and think critically to choose a safe drug. Tutor feedback was provided at the end of session. Evaluation was done to assess the students- level of interest and usefulness of the sessions in rational selection of drugs. Majority (98 %) of the students agreed that the session was an extremely useful learning exercise and agreed that similar sessions would help in rational selection of drugs. Applied learning sessions in the early years of medical program may promote deep learning and bridge the gap between pharmacology theory and clinical practice. Besides, it may also enhance safe prescribing skills.

Keywords: Medical education, pharmacology curriculum, applied learning, safe prescribing.

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Authors: Ayman M. Mansour

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In this paper, we propose an intelligent system that is used for monitoring the health conditions of patients. Monitoring the health condition of patients is a complex problem that involves different medical units and requires continuous monitoring especially in rural areas because of inadequate number of available specialized physicians. The proposed system will improve patient care and drive costs down comparing to the existing system in Jordan. The proposed system will be the start point to faster and improve the communication between different units in the health system in Jordan. Connecting patients and their physicians beyond hospital doors regarding their geographical area is an important issue in developing the health system in Jordan. The ability of making medical decisions, the quality of medical is expected to be improved.

Keywords: GSM, SMS, Patient, Monitoring system, Fuzzy Logic, Multi-agent system.

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Authors: Wondwosen Teshome

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It is impossible to think about democracy without elections. The litmus test of any electoral process in any country is the possibility of a one time minority to become a majority at another time and a peaceful transition of power. In many countries in Sub-Saharan Africa though the multi-party elections appeared to be competitive they failed the acid test of democracy: peaceful regime change in a free and fair election. Failure to solve electoral disputes might lead to bloody electoral conflicts as witnessed in many emerging democracies in Africa. The aim of this paper is to investigate electoral conflicts in Africa since the end of the Cold War by using the 2005 post-election violence in Ethiopia as a case study. In Ethiopia, the coming to power of the EPRDF in 1991 marked the fall of the Derg dictatorial military government and the beginning of a multi-party democracy. The country held multi-party parliamentary elections in 1995, 2000, and 2005 where the ruling EPRDF party “won" the elections through violence, involving intimidation, manipulation, detentions of political opponents, torture, and political assassinations. The 2005 electoral violence was the worst electoral violence in the country-s political history that led to the death of 193 protestors and the imprisonment of more than 40, 000 people. It is found out that the major causes of the 2005 Ethiopian election were the defeat of the ruling party in the election and its attempt to reverse the poll results by force; the Opposition-s lack of decisive leadership; the absence of independent courts and independent electoral management body; and the ruling party-s direct control over the army and police.

Keywords: Africa, Ethiopia, Election, Electoral violence, NEBE.

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Authors: H. Al-Khalaifa, A. Al-Nasser

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The viewpoint towards the use of drugs or vaccines against avian parasitic diseases is one of the most striking challenges in avian medical parasitology. This includes many difficulties associated with drug resistance and in developing prophylactic vaccines. In many instances, the potential success of a vaccination in controlling parasitic diseases in poultry is well-documented. However, some medical, technical and financial limitations are still paramount. On the other hand, chemotherapy is not very well-recommended due to a number of medical limitations. But in the absence of an effective vaccine, drugs are used against parasitic diseases. This paper sheds light on some the advantages and disadvantages of using vaccination and drugs in controlling parasitic diseases in poultry species. The usage of chemotherapeutic drugs is discussed with some examples. Then, more light will be shed on using vaccines as a potentially effective and promising control tool.

Keywords: Drugs, parasitology, poultry, vaccines.

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Authors: S.S.Mohanavalli, Sheila Anand

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This paper proposes a novel architecture for At- Home medical care which enables senior citizens, patients with chronic ailments and patients requiring post- operative care to be remotely monitored in the comfort of their homes. This architecture is implemented using sensors and wireless networking for transmitting patient data to the hospitals, health- care centers for monitoring by medical professionals. Patients are equipped with sensors to measure their physiological parameters, like blood pressure, pulse rate etc. and a Wearable Data Acquisition Unit is used to transmit the patient sensor data. Medical professionals can be alerted to any abnormal variations in these values for diagnosis and suitable treatment. Security threats and challenges inherent to wireless communication and sensor network have been discussed and a security mechanism to ensure data confidentiality and source authentication has been proposed. Symmetric key algorithm AES has been used for encrypting the data and a patent-free, two-pass block cipher mode CCFB has been used for implementing semantic security.

Keywords: data confidentiality, integrity, remotemonitoring, source authentication

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Authors: Abhinav Kumar, Raja Sekhar Bandaru, B Madhusudan Rao, Saket Kulkarni, Nilesh Ghatpande

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This paper proposes an algorithm which automatically aligns and stitches the component medical images (fluoroscopic) with varying degrees of overlap into a single composite image. The alignment method is based on similarity measure between the component images. As applied here the technique is intensity based rather than feature based. It works well in domains where feature based methods have difficulty, yet more robust than traditional correlation. Component images are stitched together using the new triangular averaging based blending algorithm. The quality of the resultant image is tested for photometric inconsistencies and geometric misalignments. This method cannot correct rotational, scale and perspective artifacts.

Keywords: Histogram Matching, Image Alignment, ImageStitching, Medical Imaging.

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Authors: Ning Liu, Jue Wang, Zhe Li

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The remote diagnosis and remote medical smoked to part. In China, in accordance with the requirements of different applications of remote diagnosis and Relates to the technical difference, which can be divided into special purpose remote diagnosis and treatment system, the remote will Referral system, remote medical consultation system, remote rehabilitation technology and remote operation technology. In this article, will introduce China for the special purpose of service remote diagnosis and treatment system and technology, including: China disabled status and virtual reality technology; China 's domestic family medical care system and China 's current situation of the development of telemedicine.

Keywords: China, Remote rehabilitation, The disabled people

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Authors: Essam Abd-Elrazek

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With the rapid growth in business size, today-s businesses orient Throughout thirty years local, national and international experience in medicine as a medical student, junior doctor and eventually Consultant and Professor in Anaesthesia, Intensive Care and Pain Management, I note significant generalised dissatisfaction among medical students and doctors regarding their medical education and practice. We repeatedly hear complaints from patients about the dysfunctional health care system they are dealing with and subsequently the poor medical service that they are receiving. Medical students are bombarded with lectures, tutorials, clinical rounds and various exams. Clinicians are weighed down with a never-ending array of competing duties. Patients are extremely unhappy about the long waiting lists, loss of their records and the continuous deterioration of the health care service. This problem has been reported in different countries by several authors [1,2,3]. In a trial to solve this dilemma, a genuine idea has been suggested implementing computer technology in medicine [2,3]. Computers in medicine are a medium of international communication of the revolutionary advances being made in the application of the computer to the fields of bioscience and medicine [4,5]. The awareness about using computers in medicine has recently increased all over the world. In Misr University for Science & Technology (MUST), Egypt, medical students are now given hand-held computers (Laptop) with Internet facility making their medical education accessible, convenient and up to date. However, this trial still needs to be validated. Helping the readers to catch up with the on going fast development in this interesting field, the author has decided to continue reviewing the literature, exploring the state-of-art in computer based medicine and up dating the medical professionals especially the local trainee Doctors in Egypt. In part I of this review article we will give a general background discussing the potential use of computer technology in the various aspects of the medical field including education, research, clinical practice and the health care service given to patients. Hope this will help starting changing the culture, promoting the awareness about the importance of implementing information technology (IT) in medicine, which is a field in which such help is needed. An international collaboration is recommended supporting the emerging countries achieving this target.

Keywords: Medical Informatics, telemedicine, e-health systems.

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Authors: P.S. Hiremath, Prema T. Akkasaligar, Sharan Badiger

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Speckle noise affects all coherent imaging systems including medical ultrasound. In medical images, noise suppression is a particularly delicate and difficult task. A tradeoff between noise reduction and the preservation of actual image features has to be made in a way that enhances the diagnostically relevant image content. Even though wavelets have been extensively used for denoising speckle images, we have found that denoising using contourlets gives much better performance in terms of SNR, PSNR, MSE, variance and correlation coefficient. The objective of the paper is to determine the number of levels of Laplacian pyramidal decomposition, the number of directional decompositions to perform on each pyramidal level and thresholding schemes which yields optimal despeckling of medical ultrasound images, in particular. The proposed method consists of the log transformed original ultrasound image being subjected to contourlet transform, to obtain contourlet coefficients. The transformed image is denoised by applying thresholding techniques on individual band pass sub bands using a Bayes shrinkage rule. We quantify the achieved performance improvement.

Keywords: Contourlet transform, Despeckling, Pyramidal directionalfilter bank, Thresholding.

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Authors: Hamed Bagheri, Seyd Javid Shariati

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The effects of type and amount of solvent on lubricant which is used in disposable medical devices are investigated in this article. Two kinds of common solvent, n-Hexane and n-Heptane, are used. The mechanical behavior of syringe has shown that n-Heptane has better mixing ratio and also more effective spray process in the barrel of syringe than n-Hexane because of similar solubility parameter to silicon oil. The results revealed that movement of plunger in the barrel increases when pure silicone is used because non-uniform film is created on the surface of barrel, and also, it seems that the form of silicon is converted from oil to gel due to sterilization process. The results showed that the convenient mixing ratio of solvent/lubricant oil is 80/20.

Keywords: Disposable medical devices, lubricant oil, solvent effect, solubility parameter.

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Authors: Mejía M. Paula, Ramírez L. Leonardo, Puerta A. Gabriel

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In telemedicine, the image repository service is important to increase the accuracy of diagnostic support of medical personnel. This study makes comparison between two routing algorithms regarding the quality of service (QoS), to be able to analyze the optimal performance at the time of loading and/or downloading of medical images. This study focused on comparing the performance of Tabu Search with other heuristic and metaheuristic algorithms that improve QoS in telemedicine services in Colombia. For this, Tabu Search and Simulated Annealing heuristic algorithms are chosen for their high usability in this type of applications; the QoS is measured taking into account the following metrics: Delay, Throughput, Jitter and Latency. In addition, routing tests were carried out on ten images in digital image and communication in medicine (DICOM) format of 40 MB. These tests were carried out for ten minutes with different traffic conditions, reaching a total of 25 tests, from a server of Universidad Militar Nueva Granada (UMNG) in Bogotá-Colombia to a remote user in Universidad de Santiago de Chile (USACH) - Chile. The results show that Tabu search presents a better QoS performance compared to Simulated Annealing, managing to optimize the routing of medical images, a basic requirement to offer diagnostic images services in telemedicine.

Keywords: Medical image, QoS, simulated annealing, Tabu search, telemedicine.

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Authors: F. Lievens, M. Jordanova

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Telemedicine is brought to life by contemporary changes of our world and summarizes the entire range of services that are at the crossroad of traditional healthcare and information technology. It is believed that eHealth can help in solving critical issues of rising costs, care for ageing and housebound population, staff shortage. It is a feasible tool to provide routine as well as specialized health service as it has the potential to improve both the access to and the standard of care. eHealth is no more an optional choice. It has already made quite a way but it still remains a fantastic challenge for the future requiring cooperation and coordination at all possible levels. The strategic objectives of this paper are: 1. To start with an attempt to clarify the mass of terms used nowadays; 2. To answer the question “Who needs eHealth"; 3. To focus on the necessity of bridging telemedicine and medical (health) informatics as well as on the dual relationship between them; as well as 4. To underline the need of networking in understanding, developing and implementing eHealth.

Keywords: E-Health/telemedicine, networking, medical informatics.

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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: Maninder Pal

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Medical digital images usually have low resolution because of nature of their acquisition. Therefore, this paper focuses on zooming these images to obtain better level of information, required for the purpose of medical diagnosis. For this purpose, a strategy for selecting pixels in zooming operation is proposed. It is based on the principle of analog clock and utilizes a combination of point and neighborhood image processing. In this approach, the hour hand of clock covers the portion of image to be processed. For alignment, the center of clock points at middle pixel of the selected portion of image. The minute hand is longer in length, and is used to gain information about pixels of the surrounding area. This area is called neighborhood pixels region. This information is used to zoom the selected portion of the image. The proposed algorithm is implemented and its performance is evaluated for many medical images obtained from various sources such as X-ray, Computerized Tomography (CT) scan and Magnetic Resonance Imaging (MRI). However, for illustration and simplicity, the results obtained from a CT scanned image of head is presented. The performance of algorithm is evaluated in comparison to various traditional algorithms in terms of Peak signal-to-noise ratio (PSNR), maximum error, SSIM index, mutual information and processing time. From the results, the proposed algorithm is found to give better performance than traditional algorithms.

Keywords: Zooming, interpolation, medical images, resolution.

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Authors: Panos D. Kotsas, Tony Dodd

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2D/3D registration is a special case of medical image registration which is of particular interest to surgeons. Applications of 2D/3D registration are [1] radiotherapy planning and treatment verification, spinal surgery, hip replacement, neurointerventions and aortic stenting. The purpose of this paper is to provide a literature review of the main methods for image registration for the 2D/3D case. At the end of the paper an algorithm is proposed for 2D/3D registration based on the Chebyssev polynomials iteration loop.

Keywords: Medical image registration, review, 2D/3D

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Authors: Naoki Yamamoto, Jun Murakami, Chiharu Okuma, Yutaro Shigeto, Satoko Saito, Takashi Izumi, Nozomi Hayashida

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Multi-dimensional principal component analysis (PCA) is the extension of the PCA, which is used widely as the dimensionality reduction technique in multivariate data analysis, to handle multi-dimensional data. To calculate the PCA the singular value decomposition (SVD) is commonly employed by the reason of its numerical stability. The multi-dimensional PCA can be calculated by using the higher-order SVD (HOSVD), which is proposed by Lathauwer et al., similarly with the case of ordinary PCA. In this paper, we apply the multi-dimensional PCA to the multi-dimensional medical data including the functional independence measure (FIM) score, and describe the results of experimental analysis.

Keywords: multi-dimensional principal component analysis, higher-order SVD (HOSVD), functional independence measure (FIM), medical data, tensor decomposition

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Authors: J. Alamelu Mangai, Satej Wagle, V. Santhosh Kumar

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The exponential increase in the volume of medical image database has imposed new challenges to clinical routine in maintaining patient history, diagnosis, treatment and monitoring. With the advent of data mining and machine learning techniques it is possible to automate and/or assist physicians in clinical diagnosis. In this research a medical image classification framework using data mining techniques is proposed. It involves feature extraction, feature selection, feature discretization and classification. In the classification phase, the performance of the traditional kNN k nearest neighbor classifier is improved using a feature weighting scheme and a distance weighted voting instead of simple majority voting. Feature weights are calculated using the interestingness measures used in association rule mining. Experiments on the retinal fundus images show that the proposed framework improves the classification accuracy of traditional kNN from 78.57 % to 92.85 %.

Keywords: Medical Image Mining, Data Mining, Feature Weighting, Association Rule Mining, k nearest neighbor classifier.

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Authors: Amudha Kadirvelu, Sivalal Sadasivan

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While the problem based learning (PBL) approach promotes unsupervised self-directed learning (SDL), many students experience difficulty juggling the role of being an information recipient and information seeker. Logbooks have been used to assess trainee doctors but not in other areas. This study aimed to determine the effectiveness of logbook for assessing SDL during PBL sessions in first year medical students. The log book included a learning checklist and knowledge and skills components. Comparisons with the baseline assessment of student performance in PBL and that at semester end after logbook intervention showed significant improvements in student performance (31.5 ± 8 vs. 17.7 ± 4.4; p<0.001) with a large effect size of 3.93. The learner-s log for PBL has played an important role in enhancing SDL in first year medical students. Learner-s log could be a good self-assessment tool for the undergraduate medical students.

Keywords: Problem based learning, self-directed learning, logbook, self-assessment.

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Authors: P. Gnanasekar, A. Nagappan, S. Sharavanan, O. Saravanan, D. Vinodkumar, T. Elayabharathi, G. Karthik

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In this paper we present the deep study about the Bio- Medical Images and tag it with some basic extracting features (e.g. color, pixel value etc). The classification is done by using a nearest neighbor classifier with various distance measures as well as the automatic combination of classifier results. This process selects a subset of relevant features from a group of features of the image. It also helps to acquire better understanding about the image by describing which the important features are. The accuracy can be improved by increasing the number of features selected. Various types of classifications were evolved for the medical images like Support Vector Machine (SVM) which is used for classifying the Bacterial types. Ant Colony Optimization method is used for optimal results. It has high approximation capability and much faster convergence, Texture feature extraction method based on Gabor wavelets etc..

Keywords: ACO Ant Colony Optimization, Correlogram, CCM Co-Occurrence Matrix, RTS Rough-Set theory

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Authors: Chimaobi V. Okolo, Kenneth A. Okpala, Johnbull S. Ogboi

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A teeming set of doctors that graduated from various universities within and outside Nigeria with the hope of practicing in the country, has their hope shattered because of poor financing, lack of medical equipments and a very weak healthcare systems. Such hydra headed challenges, allows room for quackery which increasingly contributes to the cause of mortality in Nigeria. With a view of reversing the challenges of healthcare delivery and financing in Nigeria, African Health Market for Equity (AHME), a project funded by the Bill and Melinda Gates foundation [With contribution from Department For International Development (DFID)] and currently implemented in three African Countries (Nigeria, Kenya and Ghana) over a Five (5) year period supports the healthcare sector via Medical credit fund (MCF). The study examines the impact of credit policy and medical credit funding on Nigerian health market. Ordinary least square analysis, correlation and granger causality tests were employed to measure the extent to which the Nigerian healthcare market has been influenced. Medical credit fund significantly and positively influenced average monthly turnover of private healthcare providers and Commercial bank’s lending rate had a weak relationship with access to credit/approved loans (13.46%). The programme has so far made 13.91% progress, which is very poor, considering the minimum targeted private health care providers (437.6) and expected number of loan approvals (180.4) for the two years. Medical credit policy in Nigeria should be revised to include private healthcare providers in rural area for more positive impact and increased returns. Good brand advert and sensitization of the programme to stakeholders and health pressure group, and an extension of the programme beyond five years is necessary to better address the issues raised in the study.

Keywords: Credit, health market, medical credit facility, policy.

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