Evolution of Responsiveness of Health System

Responsiveness is concerned with meeting the legitimate non health expectations of patients. The paper tries to explain the concept, domains and evolution of responsiveness. WHO concept of responsiveness has been criticized for using a single composite score for comparing responsiveness between countries. In spite of recognizing these issues and after much debate, no empirical research has been undertaken. Hence there is a need to recognize what constituents of responsiveness need to be reorganized, which other elements need to be added to existing WHO proposed elements of responsiveness in culturally, socially, politically different society. The paper through extensive study on responsiveness concludes the need to tailor responsiveness domains according to citizen’s priority in a particular background

Automatic Blood Vessel Extraction of Fundus Images Employing Fuzzy Approach

Diabetic Retinopathy is a retinal vascular disease that is characterized by progressive deterioration of blood vessels in the retina and is distinguished by the appearance of different types of clinical lesions like microaneurysms, hemorrhages, exudates etc. Automated detection of the lesions plays significant role for early diagnosis by enabling medication for the treatment of severe eye diseases preventing visual loss. Extraction of blood vessels can facilitate ophthalmic services by automating computer aided screening of fundus images. This paper presents blood vessel extraction algorithms with ensemble of pre-processing and post-processing steps which enhance the image quality for better analysis of retinal images for automated detection. Extensive performance based evaluation of the proposed approaches is done over four databases on the basis of statistical parameters. Comparison of both blood vessel extraction techniques on different databases reveals that fuzzy based approach gives better results as compared to Kirsch’s based algorithm. The results obtained from this study reveal that 89% average accuracy is offered by the proposed MBVEKA and 98% for proposed BVEFA

Retinal blood vessel localization to expedite PDR diagnosis

Ophthalmologist relies on the retinal fundus image segmentation for accurate diagnosis of Diabetic Retinopathy caused due to prolonged deterioration in retinal blood vessels. Blood vessel and optical disc localization determines the vascular alterations helpful in identifying retinal diseases with accurate identification of pathologies like microaneurysms and exudates. This work comprises evaluation of proposed Optical Disc Segmentation and blood vessel localization techniques followed by a statistical analysis using three fractal dimensions; box count, information and correlation. Fractal dimensions explored are beneficial for Proliferative Diabetic Retinopathy (PDR) diagnosis as its value for vascular structures increases with increasing level of PDR. Two benchmark fundus image databases, DRIVE and STARE were evaluated by utilizing shape and fractal features for performance validation and average accuracies of 96.79% and 95.68% were achieved for extracted blood vessels using proposed approach

Lossless Compression of Medical Image Sequences Using a Resolution Independent Predictor and Block Adaptive Encoding

The proposed block-based lossless coding technique presented in this paper targets at compression of volumetric medical images of 8-bit and 16-bit depth. The novelty of the proposed technique lies in its ability of threshold selection for prediction and optimal block size for encoding. A resolution independent gradient edge detector is used along with the block adaptive arithmetic encoding algorithm with extensive experimental tests to find a universal threshold value and optimal block size independent of image resolution and modality. Performance of the proposed technique is demonstrated and compared with benchmark lossless compression algorithms. BPP values obtained from the proposed algorithm show that it is capable of effective reduction of inter-pixel and coding redundancy. In terms of coding efficiency, the proposed technique for volumetric medical images outperforms CALIC and JPEG-LS by 0.70 % and 4.62 %, respectively

The role of motor nerve conduction: in cervical radiculopathy patients

Background: Cervical radiculopathy is the clinical description of when a nerve root in the cervical spine becomes inflamed or damaged, resulting in a change in neurological function. Neurological deficits, such as numbness, altered reflexes, or weakness, may radiate from the neck into the shoulder, arm, hand, or fingers. Patient also complains of tingling, numbness or loss of sensation along with the nerve root dermatome. It is a substantial cause of disability and morbidity, and its cost-effective evaluation and treatment are crucial so there is a definite need to establish a cost effective, reliable, and accurate means for establishing the diagnosis of cervical radiculopathy. Electrodiagnostic tests are the closest to fulfil these criteria out of which nerve conduction tests are one of the electrodiagnostic test.Methods: In this study motor nerve conduction of ulnar and median nerve done in 30 clinically proven cervical radiculopathy patientsResults: There are significant decrease in the conduction velocity of both nerve (median nerve (51.60±7.5), Ulnar nerve (50.60±5.6)) and significantly increased in the mean latency of both nerve (median nerve (6.02±2.4), ulnar nerve (5.8±1.8)).Conclusions: Authors concluded that MNC is the specific test for the diagnosis of cervical radiculopathy. At least the MNC of both nerves included in diagnostic criteria of cervical radiculopathy

Outcome of pregnancy in women with previous one cesarean section

Background: Worldwide rise in cesarean section (CS) rate during the last three decades has been the cause of alarm and needs an in-depth study. The purpose of this study was to determine the outcome of pregnancy in women with previous one cesarean section and maternal and perinatal complications. It also aimed at identifying the factors, which can influence the outcome of trial of labour (TOL).Methods: The prospective study was conducted in the department of Obstetrics and Gynaecology, Kamla Nehru hospital for mother and child, Indira Gandhi Medical College, Shimla, from June 2013 to May 2014 which included all women undergoing trial for vaginal birth after a previous cesarean who were more than 34 weeks, singleton viable fetus of appropriate size with cephalic presentation with inter delivery interval more than 18 months. Collected data was analysed by Student T-test and Chi-square test was used where required, for statistical analysis using Epi info 7 software. P value <0.05 was considered significant.Results: Out of 152 subjects given trial of labour, 107 (70.39%) subjects had successful VBAC and 45 (29.61%) had repeat emergency cesarean section. The maternal morbidity in emergency cesarean section group and vaginal delivered group was seen in 14 (31%), 8 (7.47%) subjects respectively. No significant perinatal morbidity was observed. VBAC rate was significantly more in women who had prior vaginal deliveries, especially in those with previous VBAC.Conclusions: In carefully selected cases, trial of labour (TOL) after a prior cesarean is safe and often successful. A prior vaginal delivery, particularly, a prior VBAC are associated with a higher rate of successful TOL

Comparative genomic analysis of novel Acinetobacter symbionts : A combined systems biology and genomics approach

Acknowledgements This work was supported by University of Delhi, Department of Science and Technology- Promotion of University Research and Scientific Excellence (DST-PURSE). V.G., S.H. and U.S. gratefully acknowledge the Council for Scientific and Industrial Research (CSIR), University Grant Commission (UGC) and Department of Biotechnology (DBT) for providing research fellowship.Peer reviewedPublisher PD

Semiautomatic detection of cardiac diseases employing dual tree complex wavelet transform

Electrocardiogram (ECG) contains lot of information which can be utilized for a mechanism to detect cardiac abnormalities. The ECG signal is too sensitive to various types of noises as it is of low frequency and has weak amplitude, these noises reduce the diagnostic accuracy and may lead to the incorrect decision of the clinician. So, denoising of ECG signal is an essential requirement for an accurate detection of Heart disease. In this paper, a Dual-Tree Complex Wavelet Transform technique (DTCWT) is presented to denoise the noisy ECG signal and to extract the Principal features followed by implementation of Peak Detection Algorithm. The performance is evaluated on the basis of performance metrics and an increase in SNR is achieved using the technique. With the proposed technique, calculated heart rate is in consensus with the gold standard of the various bench mark databases used and accurate heart disease was determined

Frequency of gall bladder metaplasia and its distribution in different regions of gall bladder in routine cholecystectomy specimens

Background: In India, gall stone disease is more common in women in the north, north east and east as compared to other zones in the country. Gall bladder metaplasia has been documented as the precursor lesion of dysplasia and therefore carcinoma. Present study was conducted to ascertain the frequency and type of metaplasia along with distribution in different regions of gall bladder.Methods: All the post cholecystectomy gallbladder samples submitted for histopathology comprised the study material. Three sections were from body, fundus, and neck each. The five microns thick paraffin sections were cut with microtome and stained with Hemotoxylin and Eosin (H and E).Results: The present study was conducted on 119 cholecystectomy specimens submitted for histopathological examination. Amongst premalignant lesions, cholecystitis with metaplasia was seen in 55 (46.2%) cases. Pyloric metaplasia without intestinal metaplasia was most common metaplasia (30.2%) followed by combined metaplasia (12.60%) and only intestinal metaplasia (3.36%). Out of 55 cases, fundus showed metaplasia in 47 followed by body (44) and neck (36).Conclusions: Very high frequency of metaplasias was observed (46.2%) in routine cholecystectomy specimen with pyloric metaplasia as the predominant type and intestinal metaplasia was accompanied with pyloric metaplasia in most of the cases. Metaplasia was found to be more or less equally distributed in different regions of gall bladder

Removal of electromyography noise from ECG for high performance biomedical systems

This paper presents the review of the biomedical system which consists of an energy source, signal processing, signal conditioning and signal transmission. These blocks are designed by various optimization techniques to achieve high operating speed, compressed area and minimum energy consumption. These techniques are mainly divided in to four aspects: (a) increasing the longevity of device using energy harvesting approaches; (b) reducing the delay to enhance the operating frequency; (c) reducing the data storage using data compression; (d) increasing the data rate transmission with reduced power consumption. This review paper briefly summarizes the various techniques and device performance achieved by these techniques. To attain these high performance systems input played a vital role. This paper also presents the different low pass IIR filter approximation method techniques to remove Electromyography noise from ECG input signal. For this purpose, we have taken MIT-BIH Arrhythmia database. We have calculated signal to noise ratio and power spectral density. On comparing their performance parameters of different low pass IIR filters, Elliptic filter has found best suited to remove this type of noise