Multi-sources data fusion framework for remote triage prioritization in telehealth.

The healthcare industry is streamlining processes to offer more timely and effective services to all patients. Computerized software algorithm and smart devices can streamline the relation between users and doctors by providing more services inside the healthcare telemonitoring systems. This paper proposes a multi-sources framework to support advanced healthcare applications. The proposed framework named Multi Sources Healthcare Architecture (MSHA) considers multi-sources: sensors (ECG, SpO2 and Blood Pressure) and text-based inputs from wireless and pervasive devices of Wireless Body Area Network. The proposed framework is used to improve the healthcare scalability efficiency by enhancing the remote triaging and remote prioritization processes for the patients. The proposed framework is also used to provide intelligent services over telemonitoring healthcare services systems by using data fusion method and prioritization technique. As telemonitoring system consists of three tiers (Sensors/ sources, Base station and Server), the simulation of the MSHA algorithm in the base station is demonstrated in this paper. The achievement of a high level of accuracy in the prioritization and triaging patients remotely, is set to be our main goal. Meanwhile, the role of multi sources data fusion in the telemonitoring healthcare services systems has been demonstrated. In addition to that, we discuss how the proposed framework can be applied in a healthcare telemonitoring scenario. Simulation results, for different symptoms relate to different emergency levels of heart chronic diseases, demonstrate the superiority of our algorithm compared with conventional algorithms in terms of classify and prioritize the patients remotely.

Endoscopic nasopharyngectomy: the Sarawak experience.

Shifting the paradigm of treatment of a locally recurrent nasopharyngeal carcinoma (NPC) from the non-surgical management to a surgical modality has always been a challenge. However, many studies on endoscopic nasopharyngectomy have proven it to be a reliable form of treatment with an excellent outcome. Since 2007, in Sarawak General Hospital, six cases of endoscopic nasopharyngectomy for locally recurrent NPC have been performed with encouraging results.

Nasopharyngeal Carcinoma Database.

Nasopharyngeal carcinoma (NPC) is a cancer which is common in Asia. We report the establishment and early results of a multi-institutional prospective study of nasopharyngeal carcinoma, which seeks to systematically collect data as well as blood and tumour tissue samples from patients diagnosed with nasopharyngeal cancer at six centres in Malaysia. A total of 484 confirmed NPC cases were reported from the six participating centres between 1st July 2007 and 29th February 2008. Of these, 225 were newly diagnosed cases, 53 were recurrent cases and 206 were in remission at the time of reporting. Amongst the newly diagnosed cases, the most common presenting symptom was the presence of neck lumps (42%). Ophthalmo-neurologic symptoms were the presenting symptoms of 11% of the new cases. The majority of cases (75%) presented at stage III/IV.

Neonatal post-intubation subglottic stenosis.

Acquired subglottic stenosis is a compication or neonatal endotracheal intubation. Although it is rare, it contributes significantly to the morbidity and physical well being of post extubated neonates. A 20-day old neonate, ventilated for meconium aspiration syndrome and persistent fetal circulation, presented with marked stridor and respiratory embarrassment. A stenosed subglottic area was found on rigid bronchoscopy. Anterior cricoid split was performed to relieve the obstruction. He is asymptomatic post operatively.

Psychiatric aspects of hysterectomy.

A prospective psychiatric study of women undergoing hysterectomy conducted in Christian Medical College, Vellore, is described. About 20% of patients who had Hysterectomy developed depressive symptoms during the first year of follow up. Those who developed these symptoms had higher N score on Eysenck Personality Inventory and a higher M. R. Score on Cornell Medical Index before the operation when compared to those who did not develop psychiatric symptoms which suggests that the patients who have a higher score on Neuroticism are more prone to get psychiatric illness. It is emphasised that an attempt must be made to identify such patients who are more prone to get psychiatric disturbance in order to prevent or minimise these psychiatric disturbances. Prior consideration to these complications should be given before doing hysterectomy.