IMJ Health : April 2018

Medical Journal: Published volume-4, Issue-4, April 2018 with ad publications

Design and Architecture of Intelligent Medical Machines:  A Research Paper

Abstract— Commonalities between the engineering rigor and the medical approach were explored to solve problems and present generic platforms to fuse the engineering rigor into the current medical approach to resolve the concerns of medical machine designers. The design methodology stresses the ability to fragment medical problems and their procedures into a series or a combination of minor or even microscopic problems (and their procedures) which are resolved by enforcing one or more actions by intelligent agents (or noun objects) to solve the localized problem. A certain amount of knowledge in the solution process is fed back to customize the specific solution for the specific patient. A series of minuscule of such knowledge modules are appropriately integrated to solve the entire medical problem for the patient. This minuscule’s of knowledge become programmable instruction for a medical machine with access to World Wide Web and knowledge bases that can verify and enhance the solution strategy for the fragmented problems.

The role of knowledge and its programmability become crucial to finding an optimal and efficient solution to solve routine, mid-sized or large medical problems of the patients during routine doctor’s visits. It is our contention that the suggested approaches in blending the industry wide practices in the design and manufacture of digital devices and systems can reduce the cost of providing medical services substantially. With reasonable care in selecting the intelligent agents (doctors, staff, instruments, laboratories, and/or medicines), their respective actions and functions in efficient and effective combinations at appropriate instants of time can be a significant step forward in cost reduction and (near) flawless administration of medical procedures.

The paper spans numerous disciplines ranging from mathematics, computer and knowledge science, the science of management including program evaluation and review technique (PERT) and optimization of strategies. The role of these disciplines is incisive and restricted the practice of medicine and the many roles that computer systems that are essential building blocks of medical machines.

Keywords: Medical Machines, Evolution of Medical Processor Units, Intelligent Medical Processor Units.

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Assessment of Stress, Attention and Memory in High School Students in Latacunga, Ecuador: A cross-sectional survey

Abstract—Stress is the side effect of development. Nowadays school going children also had stress and it’s after effects. So this research was carried out in order to evaluate indicators of stress level (stress test), attention (Toulouse-Pièron test), immediate memory (word list test) and working memory (reverse order digit test), to a group of 40 students of the school whose age was between 15 and 17 year. Survey done on first of April in the International Baccalaureate level of the Latacunga city, Cotopaxi province, Republic of Ecuador. The perceptual and attention testing Toluuse-Pièron for additions and omissions plus errors did not throw significant differences between gender; but they behaved over 20 % of the hits, which showed a lack of deep concentration and attention over time. The stress test showed that females were more stressed in relation to males; however, for the word test and the reverse-order digits, no significant differences between the genders were found. A nonlinear (polynomial) relationship was found between the stress of the students and the memory. So it can be concluded that females were significantly more stressed than males whereas regarding memory there was no significant difference in both the sexes. It was also revealed that there was no linear relation between stress and memory.

Keywords: Stress, Attention, Memory, Concentration.

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Comparative Study on Macroscopic Morphology of Human Placenta in Preterm, Term & Post Term Pregnancy

Abstract— Pregnancy is highly precious for every couple but presence of risk factors that cause prematurity, post maturity and various other conditions that complicate the pregnancy have adverse effects. Gross examination of the placenta may provide useful information about the etiology of newborn and maternal complications. Hence it is important to study relationships between placental abnormalities, gestational age and occurrence of adverse outcome. So, this study aims to compare the macroscopic morphology of human placenta in preterm, term and post-term pregnancy. A hospital based comparative observational study conducted on placentae of 40 pre-term, 40 term and 40 post-term. Shape, weight, diameter, thickness, mode of insertion of umbilical cord, number of cotyledons and arrangement of chorionic vessels was observed of each placenta included in the study. These variables of palcentae were compared as per pre-term, term and post-term. Significance of difference was determined by Chi-square test. This study revealed that most of the placentae were discoidal in shape. And the weight as well as diameter of the term placentae were significantly more from preterm placentae. Likewise weight and diameter both of the post term placentae were significantly more form term placentae. Regarding thickness of placentae, term placentae thickness were more from preterm placentae and post-term placentae were more from term placentae but it was found significant in term to preterm not in term to post-term. So it can be concluded from this study that as gestational period increases weight, diameter and thickness of placenta increases. Observing the facts, more studies are suggested to explore the other variables related to placenta and its relation to pregnancy outcomes.

Keywords: Placenta, Macroscopic anatomy of Placenta, Pregnancy Outcomes.

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VACTERL association: A Case Report of a congenital malformations

AbstractVACTERL / VATER association is defined by the presence of at least three of the following congenital malformations: vertebral defects, anal atresia, cardiac defects, trachea-esophageal fistula, renal anomalies and limb abnormalities. It is diagnosed clinically by the above features with presence of core component features like trachea-esophageal fistula or ano-rectal malformations. Etiology is largely unknown. Management centers on surgical correction of the specific congenital malformations in the immediate postnatal period followed by long term treatment of the sequelae. Prognosis is good if surgical correction is achieved but majority continue to be affected by their malformations throughout life.

Keywords: VACTERL Association, Congenital Malformations.

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Correlations of Serum Level of 25(OH)D and Bone Mineral Density (BMD) among chronic patients of Spinal Cord Injury (SCI)

Abstract—Chronic patients of spinal cord injury has been detected severe reduction of bone density. Patients with SCI show mostly osteopenia or osteoporosis of the hip and spine. Vitamin D deficiency may contribute to development of osteoporosis in SCI. So a study was conducted on 100 chronic SCI patients to find out status of correlation of Vitamine D and bone mineral density (BMD). Blood samples were collected and investigated routine biochemistry with serum 25(OH)D. DXA scan of hip and spine was also done. This study observed that 55% patients had suboptimal vitamin D. Positive correlation was found between vitamin D & bone mineral density. It is concluded from this study that monitoring of Serum 25(OH)D levels and annual surveillance of bone mineral density is crucial among persons with chronic SCI to reduce progression of osteoporosis and minimize the risk for further fractures.

Keywords: 25(OH)D: 25 Hydroxy Vitamin D, DXA: Dual Energy X-Ray Absorptiometry, BMD: Bone Mineral Density.

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Assessment of Knowledge and Practices regarding personal hygiene among students of Government schools of Jaipur city: A cross-sectional survey

Abstract— Hygiene practices are very important, poor hygiene results into various communicable diseases. These hygiene practices can have cultivated in Childhood. School children are particularly vulnerable to neglect the basic personal hygiene. So this study was conducted on 1385 school children to assess the status of knowledge and practices of their hygiene with the source of their knowledge. This study was conducted on 1385 students of 6 selected schools of Jaipur city. It was observed that it was observed that 98.4% had knowledge about body and clothes hygiene, 95.2% had knowledge about teeth brushing, 92.5% had knowledge about regular clothes washing, 89.2% had knowledge about soap use in personal hygiene, 50.3% had knowledge about use of toilet paper, 78.8% had knowledge about use of nail cutter and 37.1% knowledge about sanitary pad. And 97.3% practice for bath & brush teeth every day, 95.1% practiced for hand wash before meal, 74.3% practiced for hand wash before cooking, 66.6% practiced for hand wash after cooking, 90.2% practiced for hand wash after using toilet, 87.8% practiced for hand wash after handling garbage, 75.7% practiced for hand wash after handling animal, 73.6% practiced for cutting nails in < 7 days, 80.8% take hair cut out in < 1 month, 70.1% use soap as hygiene product, 42.7% use facial tissue as hygiene product and 50.1% use cotton swab as hygiene product.

Keywords: Hygiene, Knowledge, Practices, School Children.

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Clinical assessment of Fetal weight estimation using Johnson’s formula & Ultrasonographic assessment using Hadlock’s formula at or near term: A comparative observational study

Abstract—Fetal weight in conjuction with gestational age is an important indicator of pregnancy outcome. So this study was conducted to find out the better method among using Johnson’s formula or using Hadlock’s formula to estimate fetal weight antenatally at or near term. This prospective study conducted on 100 pregnant women selected by simple random sampling with single term pregnancy with no fetal anomalies, delivered within one week of ultrasonography as well as measuring the symphysiofundal height and accuracy of Johnson’s and Hadlock’s formula compared. Fetal Weight is overestimated in all groups by Johnson’s formula whereas in Hadlock’s formula there is underestimation of birth weight <2500 gms and >3500 gms babies and overestimation between 2500-3500 gms babies. The correct weight was estimated with an error of 100gms in 30% of cases by Johnson’s formula and in 68% of cases by ultrasound Hadlock’s method. Although Hadlock’s formula was found relatively more accurate than Johnson’s formula in predicting birth weight but Johnson’s formula is a quick, easy, accurate, reliable and cost effective method for estimating the fetal weight in remote areas where ultrasound is not available if assessed by experienced obstetricians. Despite the superiority of ultrasonography the simple clinical method of predicting fetal weight is of great value especially in developing countries.

Keywords: Fetal Weight, Johnson’s Formula, Hadlock’s Formula.

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Comparison of diagnostic efficacy of USG, Tuberculin test, Nucleic acid amplification test (PCR) & histopathology for diagnosis of genital tuberculosis in infertile women, assuming culture as gold standard

Abstract— Female genital tuberculosis is one of the major etiological factors of female infertility. Diagnosis of genital tuberculosis is very important in such cases. So this comparative observational type of study was carried out on infertile women to compare the diagnostic effectively of ultrasonograpgy (USG), genital tuberculosis, Tuberculin test, Nucleic acid amplification test (PCR), histopathology and hysteroscopy & laparoscopy (DHL) assuming culture as gold standard. It was observed that the 28% of infertile cases were found positive for genital tuberculosis on culture. Sensitivity of PCR 64.28%, DHL 92.85%, USG 42.85%, Histopathology 60.71% and Tuberculin Test 64.28%. So sensitivity was found with significant variation ranging from 42.85% with ultrasonography (USG) to 92.85% with DHL. Specificity of PCR 52.77%, DHL 55.55%, USG 98.61%, Histopathology 91.66% and Tuberculin Test 36.11%. So specificity was also found with significant variation being found maximum with USG (98.61%) and minimum with tuberculin test (36.11%). Positive predictive value (PPV) was found maximum (92.3%) with USG and minimum (28.12%) with tuberculin test and negative predictive value (NPV) was found maximum (95.23%) with DHL and minimum (72.22%) with tuberculin test. Diagnostic effectively of diagnosing GTB with various studied modalities vary with significant variation.

Keywords: Infertility, diagnostic efficacy, genital tuberculosis, Tuberculin test, Nucleic acid amplification test (PCR).

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Burden of infertility and its associated factors: A cross sectional descriptive analysis of infertility cases reported at a tertiary level hospital of Rajasthan

Abstract—In many cultures in India, womanhood is defined through motherhood and infertile women usually carry the blame for the couple inability to conceive. A childless woman is stigmatized and sometimes not allowed to participate in various auspicious ceremonies, particularly those involving childbirth. The present study was undertaken in S.M.S. Medical College, Jaipur, Rajasthan to find out the factors contributing to infertility and the health seeking behavior of infertile women. A hospital based observational study was carried out in year 2017 on eligible women attending OPD of Obstetrics and Gynecology at Mahila Chikitsalaya, S.M.S. Medical College Jaipur. A total 1000 eligible women were recruited using systematic random sampling and interviewed using a predesigned and pretested questionnaire. A total of 119 women (11.9%) were found to be infertile. Age of women, caste, residence, education status of women, occupation, family size and socio-economic status were found to be significantly associated with infertility (P<0.05). Lower age of women, OBC caste, urban residence, less family size, lesser education status of women, housewives and middle socio-economic status were found to have significantly more infertile females than their counterparts. Age of women, type of family and religion were not found to be associated with infertility (P >0.05). Improving awareness about infertility and its management could help reduce the burden and its social implications.

Keywords: Infertility, Infertile Women.

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