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Appropriate Medical Technology for Developing Countries (Ref. No. 2002/057), IEE Seminar on

Date 6-6 Feb. 2002

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Displaying Results 1 - 22 of 22
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  • Analysis of mammographic microcalcifications using gray-level images and neural networks

    Page(s): 11/1 - 11/4
    Save to Project icon | Click to expandQuick Abstract | PDF file iconPDF (335 KB)  

    At present, Mammography associated with clinical breast examination and breast self-examination is the only effective and viable method for mass breast screening the presence of microcalcifications is one of the primary signs of breast cancer. It is difficult however, to distinguish between benign and malignent microcalcifications associated with breast cancer. Most of techniques used in computerized analysis of Mammographic microcalcification use the shape features on the segmented regions of microcalcifications extracted from the digitized Mammographs. Since Mammographic images usually suffer from poorly defined microcalcifications features, the extraction of shape features based on a segmentation process may not accurately represent microcalcifications. The intensity variations and texture information in the area of interest provide important diagnostic information about the underlying biological process for the benign or malignent tissue and therefore should be included in the analysis. In this paper, we define a set of image structure features for calcification of malignancy. Two categorizes of correlated gray-level images structure features are defined for classifications of "difficult-to-diagnose" cases. The first based features representing the global texture and the wavelet decomposition-based features representing the local texture of the microcalcification area of interest. The second category of statics of the segmented microcalcification regions and the size, number, and distance features in each category were correlated with cluster. Various features in each category were correlated with the section of the best of features of the segmented calcification cluster. Various features in each category were correlated with the biopsy examination results of a lots of "difficult-to-diagnose" cases gray-level images structure information. The selection of the breast features was performed using the multivariate cluster analysis as well as a genetic algorithm (GA)-based search method the neural network and parametric statistical classifiers receiver operation characteristic (ROC) analysis was performed to compare the neural network based classifications with linear and nearest neighbor (KNN) classifiers. Then neural network classifier yielded between resul- ts using once combined set of features selected GA based search method for classification of "difficult-to-diagnose" microcalcifications. View full abstract»

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  • Twinning over the Internet [medical equipment repair]

    Page(s): 12/1 - 12/2
    Save to Project icon | Click to expandQuick Abstract | PDF file iconPDF (274 KB)  

    The idea of one to one relationships between departments in developed and developing countries has been around for several years. In the 1980s a survey by the IAEA showed that a large proportion of equipment supplied to developing countries was out of action but this was often for the want of a component costing just a few dollars. As part of a spare parts project, laboratories in developed countries would supply small items to 'twins' in developing countries and be reimbursed by the IAEA. One argument against such a scheme was that a component destined for a gamma camera could end up for example in a professor's television. A small amount of such leakage would be trivial compared with the effective loss of money in expensive equipment standing idle. The integrity of health workers and the common desire to run a successful department should reduce this leakage to a very small proportion of the cost of supplying the apparatus. View full abstract»

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  • Healthcare technology information system: the case study of Mozambique with an eye on global approach for developing and in-transition countries

    Page(s): 2/1 - 2/11
    Save to Project icon | Click to expandQuick Abstract | PDF file iconPDF (640 KB)  

    An accurate, reliable, comprehensive and easy to use information system (IS) is a key factor for the development, monitoring and control, i.e., management, of any system. In the healthcare sector this is truer than ever, and in the sub-sector of healthcare technology management (HTM) is, sometimes, a major missing factor. When considering HTM in developing countries, an IS, is, most of the time, disregarded as a high tech instrument that does not add any value to a weak maintenance system. In addition to this common belief, available packages have been developed in and for westernised countries where HTM is different. In developed countries, the level of the economy, the profit margin and the one fits all product allow for a prolific but not exportable market. However, there have been packages written for developing countries. Unfortunately, these were products of a specific project with no background methodology or proposal for future sustainability. In Mozambique during the last 4 years, an HTM-IS system has been developed and re-written three times. It has been based on a pre-defined document, which, along the years, evolved with the package, into a full methodology document written as a framework for HTM-IS development. In this brief article, the application of the HTM-IS in Mozambique along with its results is presented. Moreover, the methodological document for developing HTM-IS is described with its major features. View full abstract»

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  • PhiSAS: a low-cost medical system for the observation of respiratory dysfunction

    Page(s): 10/1 - 10/5
    Save to Project icon | Click to expandQuick Abstract | PDF file iconPDF (495 KB)  

    Respiratory illness is recognised internationally as one of the commonest medical disorders affecting the world's populous, and is especially a major problem that affects the third world. The World Health Organisation (WHO) pursues an extensive health program that is aimed at reducing the plight of respiratory disorders by treatment and education. As with the majority of third-world health care programs, the effectiveness is limited by the availability of resources and finance. PhiSAS (Physiological Signal Analysis System) is a novel system developed for the observation of lung sounds. The system consists of a Personal Computer (PC) supported with dedicated software and hardware. Lung sounds can be recorded via chest microphones into the computer system for storage in digital form. This data can then be retrieved for post-processing using an array of software-based Digital Signal Processing (DSP) techniques that can mathematically manipulate lung sounds to extract important features. Data and results can be presented audibly by sound playback, or graphically by using spectrographs. The spectrograph is a representation of lung sound spectral energy with respect to time and frequency. PhiSAS has the ability to present three types of analysis based on conventional and novel mathematical techniques: Fourier, Wavelet and Time-Frequency Analysis. The purpose of the PhiSAS system is to provide objective analysis of lung sounds. The practice of auscultation (the art of listening to body sounds) has been practiced by physicians since the days of Hippocratic medicine. However, many physicians believe that respiratory auscultation performed with a stethoscope offers little scientific value due to the way it is practiced. For example, observations can be subjective depending on the physicians hearing ability and experience. Moreover, descriptions of lung sounds are described using onomatopoeic references that are ambiguous. By exploiting advances in low-cost PC technology and techniques in signal analysis, the physician can express sound observations in a more precise scientific manner. View full abstract»

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  • Bio-medical engineering in health-care

    Page(s): 16/1 - 16/5
    Save to Project icon | Click to expandQuick Abstract | PDF file iconPDF (442 KB)  

    Today medical equipment is so complex and the choice is so extensive that the hospitals are now forced to pay dose attention to the management of the medical equipment technology. The technology management is an accountability, systematic approach to assuring that cost effective, efficacious, safe and appropriate equipment is available to meet the demands of quality patient care. This trend has made the role of Bio-medical engineers crucially important and recognizable. The Bio-medical engineer is not only responsible for maintenance and service but also for the pre-purchase technical evaluation and appraisals, users education and training, timely replacement and risk management of the equipment and systems. The bio-medical engineer as such contributes to a hospital's efficiency and to effective and high quality patient care by closely working with clinical staff, chief medical officers, department heads and administrators. View full abstract»

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  • The design of very low cost incinerators for emergency situations in developing countries

    Page(s): 17/1 - 17/4
    Save to Project icon | Click to expandQuick Abstract | PDF file iconPDF (339 KB)  

    The project has proved highly successful. A prototype of the portable incinerator has been made and erected and initial tests carried out. The weight of the prototype was 250 kg. It was shown that all cement mouldings could be made from a jig, and that therefore there was no need to tailor the steelwork to fit the masonry elements. The prototype was erected by two (elderly) people in five hours once delivered to site, and could be fired up immediately. The cost was reduced by half from the original Mark 1 design. It is proposed to build the components of about 10 of this model and keep in a central store for use when future emergencies break out, as sadly they surely will. View full abstract»

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  • New diagnostic tools to help control epidemic sleeping sickness (in Africa) and other endemic and opportunistic diseases in the rural areas - by regular medical and veterinary surveillance

    Page(s): 20/1 - 20/13
    Save to Project icon | Click to expandQuick Abstract | PDF file iconPDF (1007 KB)  

    The following tools are discussed: PimaTM reader card; SpinetteTM microcentrifuge; SpindoctorTM microcentrifuge disc; JabricTM multi-purpose manual centrifuge; Solacen (A)TM portable electric microhaematocrit centrifuge; Solacen (B)TM portable electric centrifuge; Portasol solar panel; AnaemaScan electronic Hb meter with digital read-out; SolmicTM independently powered field microscope. View full abstract»

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  • A biomedical instrument development center

    Page(s): 14/1 - 14/3
    Save to Project icon | Click to expandQuick Abstract | PDF file iconPDF (371 KB)  

    We propose a biomedical instrument development center based in a University in a developing country. This Center is chartered to develop medical instruments based on commodity computers and computer components. The Center will produce world-class products which meet the strictest of US and World standards. The products must be perceived as new and innovative and better than currently available products. The Center will have a strong business focus. Projects and proposals will be initiated and continue on the basis of a sound business plan. View full abstract»

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  • Can middle income countries catch up in cancer treatment?

    Page(s): 8/1 - 8/4
    Save to Project icon | Click to expandQuick Abstract | PDF file iconPDF (397 KB)  

    Our aim in this paper is to set out some realistic options for improving cancer treatment in middle income countries. Most discussion has focused on prevention with less attention to the actual service options open to such countries (in the income range $4-10,000 per head). We would support a strong emphasis on prevention but we see service as a complementary priority. Better access to effective treatment will increase the incentives to adopt preventive approaches. View full abstract»

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  • Further developments of the de Montfort medical waste incinerator

    Page(s): 23/1 - 23/11
    Save to Project icon | Click to expandQuick Abstract | PDF file iconPDF (612 KB)  

    The initial design of this simple and cheap incinerator was described in the First Seminar (UK ISSN 0963-3308 Ref. No.. 2000/014) Since that time, our efforts have been in two major directions. (a) To implement the technology wherever it was needed in developing countries, and (b) to modify the design to meet the specific requirements of the Aid Organizations who were the main users. Initial propagation of the design was by direct contact with potential users, and by publications and presentations at meetings and with much help from ECHO Health Services and ITDG who had already considerable presence in the field. Once it was known to the Aid Organizations, little further publicity was needed. Up to now, we know of over 500 incinerators built or planned in about 25 countries, and the authors have taken part in teaching programmes to disseminate the design in several regions. View full abstract»

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  • Health measurements, numeracy, and development

    Save to Project icon | Click to expandQuick Abstract | PDF file iconPDF (189 KB)  

    Growth monitoring was introduced in the 60's and spread throughout the South in the 70's. In the 80's cost benefit analysis showed that, unlike immunisation and oral rehydration, it had no influence on nutrition levels or mortality. The reason became apparent in discussion with those concerned with primary education. Graphic representation of number was not taught in primary schools and was not understood by a majority of health workers including some doctors. This situation was altered with the introduction of a simple method of weighing - the Direct Recording Scale [DRS]. When the mother releases the weight of her child into the trousers below the scale she sees a large spring stretch up her child's chart which has been placed in the scale. She then introduces the next point on her child's growth curve with a ball pen through a hole in the pointer at the top of the spring. She can then compare this with entries made in previous months [moons]. Totally unschooled mothers and grandmothers come to understand faltering in growth and will take action. If simple low-cost technology such as the DRS can lead to apparent appreciation of something as complex as a line graph it suggests that other measuring devices may also help in the understanding of practical numeracy and empower the mothers and families to take action. These low cost technologies may include: Height measures in schools. Mid upper arm insertion circumference tapes. Pubic - Fundal Height measures which give graphic representation of growing foetus. Thermochromatic thermometers, reusable costing only pence. ThermoSpot. A black 12 mm disc stuck on new born infants which changes to a green smiling face if >35.5°C. Anaemia-check. Blotting paper method of checking haemoglobin accurate to 1 gm. Two ended spoon for home measurement of sugar and salt for oral rehydration. View full abstract»

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  • Progress on the Glostavent Project

    Page(s): 22/1 - 22/4
    Save to Project icon | Click to expandQuick Abstract | PDF file iconPDF (347 KB)  

    The Glostavent project was initiated because modern anaesthetic machines have become so sophisticated and complex that at #20-#40,000 each, they are now no longer affordable in most developing countries. Moreover, they are not designed for use in adverse environments or where the supply of electricity or oxygen may be interrupted without warning, as this will immediately render them totally unworkable with catastrophic results. Furthermore, they require a much higher standard of maintenance and servicing than is likely to be available in these situations. For this reason, the supply of unsuitable and over sophisticated anaesthetic equipment to the developing world, has consistently been shown to result in failure and to be an expensive waste of resources. In order to reverse this process and to provide aid for our colleagues which represents value for money, a completely new anaesthetic machine called the Glostavent has been designed specifically to overcome the difficulties encountered by those working in unfavourable conditions. At #7,500, it is much less expensive to purchase, it is more economical to run, easy to understand and operate and is robust requiring minimal servicing. It can be used on both adults and children, either as an anaesthetic machine in the operating room, or as a ventilator in an intensive care unit or recovery room. Most important of all, it can continue to function without interruption if the supply of oxygen or electricity is interrupted, situations which are all too common in the developing world and have been responsible for many avoidable tragedies. It incorporates 4 components, each of which has in its own right already proved valuable to anaesthetists in the developing world. They are the draw-over anaesthesia system, the Manley Multivent ventilator, the oxygen concentrator and the air compressor. View full abstract»

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  • The global medical devices nomenclature: a summary

    Page(s): 3/1 - 3/12
    Save to Project icon | Click to expandQuick Abstract | PDF file iconPDF (446 KB)  

    Why do we need a special nomenclature for medical devices, and of what exactly does such a nomenclature comprise? To understand this need it is important to understand the scope of the term "Medical Device". The definition of a medical device indicates that this is a very broad term and relates in summary to "instruments, apparatus, appliances etc. used for human beings for diagnosis, prevention, monitoring, treatment, investigation with reference to disease, injury, handicap." There are many technologies concerned in the field of medical devices, and the range of products extend from small needles, rubber catheters and tubes, to electronic monitors for a multitude of purposes, to anaesthetic equipment, dialysis equipment, X-ray machines and other scanners as examples taken from a list of many thousands. When identifying a need or a problem with a device, there is a need to have a list of generic terms, which can narrow down the identification process. The global nomenclature GMDN includes approximately 7,000 preferred generic terms, each with a full definition of the general features covered and a further 7,000 synonym terms to cover alternative routes to the main terms and other 'template' or less detailed general headings. When the manufacturer identifies his range of products (or type) with each having trade titles, names and model numbers the range of generic terms can describe in a general way many hundreds of thousands of actual products on the market. View full abstract»

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  • Tools and training: a practical approach towards improving healthcare equipment maintenance in The Gambia

    Page(s): 9/1 - 9/5
    Save to Project icon | Click to expandQuick Abstract | PDF file iconPDF (517 KB)  

    A pilot project is described which consisted of two core components: a course, which would be of three weeks duration, with the possibility of a one-week supplementary 'advanced' course if considered appropriate, and the provision of toolkits, test equipment and spare parts. The project would also include follow-up visits to evaluate the effectiveness and usefulness of the course. The findings outlined here would seem to confirm not only that there is a vast need for this kind of programme, but also that even a short-duration 'basic' course can have a significant impact. The provision of training in combination with tools, spares and on-going support has been seen to be an essential combination; one without the other would be not nearly as beneficial. View full abstract»

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  • Veterinary and wildlife training in East Africa: a practical approach

    Page(s): 21/1 - 21/8
    Save to Project icon | Click to expandQuick Abstract | PDF file iconPDF (470 KB)  

    Although the emphasis on the Courses and Workshops in East Africa is on wild (free-living) animals, there is considerable coverage of material relating to domestic animals and to the health and well being of humans. This is important because, as populations of Homo sapiens in East Africa grow, the interface between them, their domestic stock and wildlife becomes more blurred. Therefore, devising and teaching programmes and in promoting the use of appropriate field equipment, there is much merit in looking at what is already established in human medicine to if this might be adapted to work with animals. Interestingly, sometimes the flow is reversed, with developments in the veterinary field proving applicable and beneficial also to human beings. The opportunities for collaboration in this important area have never been greater. View full abstract»

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  • Cobalt 60 teletherapy for cancer: a revived treatment modality for the 21st century

    Page(s): 19/1 - 19/19
    Save to Project icon | Click to expandQuick Abstract | PDF file iconPDF (1377 KB)  

    Using a modern, commercial, 3D treatment planning system, we have been able to demonstrate that comparable quality external beam treatment plans can be achieved using a cobalt unit, when compared to current practice on a linear accelerator fitted with a multi-leaf collimator (MLC). Other lesions that we have found to show equal promise include small to medium breasts, parotid gland, maxilliary antrum and oesophagus. The reduced energy dependence that is suggested in IMRT plans would, of course, require a well designed beam compensation system to be a practical and efficient alternative to MLC based linac treatments. However, for conformal radiotherapy, divergent blocks provide the gold standard of 'beams eye view' conformality with their 'infinitely small' leaf width resolution. In general, MLC's can increase the penumbra of linac beams up to and beyond conformally blocked cobalt fields. View full abstract»

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  • Some equipment management systems for use in developing countries

    Page(s): 13/1 - 13/5
    Save to Project icon | Click to expandQuick Abstract | PDF file iconPDF (375 KB)  

    There are additional issues to those typically encountered in developed countries when transferring technology from developed to developing countries. However, it was found possible to derive a range of selection criteria, which can be modified for any particular situation. It was found that the paper-based systems, because of their robustness and ease of use, were more appropriate for developing countries. However, it is believed the effort should be made to use computer-based systems where viable, because of their extra features and reporting facilities. View full abstract»

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