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Biomedical subjects

S Kishore

Publications and source records attributed to S Kishore.

16 recordsLinked to original sources
PubMed1998

Trans-telephonic electrocardiographic monitoring--experience in India.

A centre for trans-telephonic electrocardiographic monitoring (TTEM) was established at the Escorts Heart Institute in May 1996. We have reviewed our experience in the first 398 patients. There were 321 males (81%) and 77 females (19%); their age range was 1 month to 95 years. Sixty-five per cent of patients were from New Delhi, while the remainder were from other cities in India and abroad. As well as follow-up of patients after discharge, the system was used for the evaluation of chest pain, palpitation, chronic angina, arrhythmias, and pacemaker implants. Out of 664 symptomatic transmissions, 510 (77%) were for cardiac symptoms like chest pain (309), palpitation (90), uneasiness (61), dizziness (28) and breathlessness (22); the other 154 (23) were for non-cardiac symptoms like stitch pain and backache (51), typical chest pain (39), weakness and fever (45), and sweating (19). The majority of patients with chest pain (84%), palpitation (78%) and dizziness (75%) transmitted their electrocardiograms within one hour of the onset of the symptoms. Out of 664 symptomatic transmissions, 531 required either reassurance or drug-dose adjustment by telephone and 97 were called to the outpatient department on an elective basis. Immediate hospitalization was advised for 36 patients, for acute management of their symptoms. TTEM was useful in avoiding 628 unnecessary visits to the hospital, while 36 patients were immediately hospitalized for acute care.

Adolescent↗
PubMed1998

Trans-telephonic electro-cardiographic monitoring (TTEM)--first Indian experience.

Trans-Telephonic Electro-Cardiographic Monitoring (TTEM) centre, is an easy to use tool, now freely available in India. Between May 1996 and May 1997, 398 patients were registered at Escorts Heart Alert Centre (EHAC) for TTEM; 321 (81%) males and 77(19%) females. Age range was from 1 month to 95 years 65% patients were from New Delhi; 35% from other cities in India and abroad. Patients' clinical profile were post-CABG, post-PTCA, post-MI, patients after discharge; evaluation of chest pain, palpitation, chronic angina, arrhythmias, and pace-maker follow up. Out of 664 symptomatic transmissions, 510 (77%) were for cardiac symptoms like chest pain 309 (61%); palpitation 90 (18%); uneasiness 61(12%); dizziness 28(5%) breathlessness 22(4%). 154(23%) were for non-cardiac symptoms like stitch pain and backache (51); Atypical chest pain (39); weakness and fever (45) and sweating (19). 84%, 78% and 75% patients of chest pain, palpitation and dizziness respectively transmitted their ECGs within one hour of the onset of the symptoms. Out of 664 symptomatic transmissions, 531 required either re-assurance or drug-dose adjustment on telephone. 97 were called to OPD on elective basis. 36 patients were advised immediate hospitalization, for acute management. TTEM was useful in avoiding 628 unnecessary visits to the hospital whereas 36 patients, were immediately hospitalized, for receiving acute life-saving interventions.

Adolescent↗
PubMed1996

Factors affecting the electronic communication of radiological information to an intensive-care unit.

In order to examine communication of radiological information under circumstances where rapid exchange of information was essential, we studied communication of non-routine portable chest radiographs to an intensive-care unit (ICU). Images and reports were available through the usual communication channels and through a PACS workstation in the ICU. Data were obtained to determine how quickly and by what means ICU physicians first viewed images and received radiologists' reports of chest radiographs. Peak information demand occurred within 4 h of the examination. The most rapid means of communication was for the physician to visit the radiology department. Image viewing and report receipt were tightly coupled, usually for images which were first viewed as hard copy. PACS performance suffered from unreliable film digitization and delayed report transcription. Integration of computed radiography and digital dictation into a PACS could markedly reduce the delays in ICU physicians' access to radiological information.

Efficiency, Organizational↗
PubMed1995

A methodology for the economic assessment of picture archiving and communication systems.

Most economic studies of picture archiving and communication systems (PACS) to date, including our own, have focused on the perspectives of the radiology department and its direct costs. However, many researchers have suggested additional cost savings that may accrue to the medical center as a whole through increased operational capacity, fewer lost images, rapid simultaneous access to images, and other decreases in resource utilization. We describe here an economic analysis framework we have developed to estimate these potential additional savings. Our framework is comprised of two parallel measurement methods. The first method estimates the cost of care actually delivered through online capture of charge entries from the hospital's billing computer and from the clinical practices' billing database. Multiple regression analyses will be used to model cost of care, length of stay, and other estimates of resource utilization. The second method is the observational measurement of actual resource utilization, such as technologist time, frequency and duration of film searches, and equipment utilization rates. The costs associated with changes in resource use will be estimated using wage rates and other standard economic methods. Our working hypothesis is that after controlling for the underlying clinical and demographic differences among patients, patients imaged using a PACS will have shorter lengths of stay, shorter exam performance times, and decreased costs of care. We expect the results of our analysis to explain and resolve some of the conflicting views of the cost-effectiveness of PACS.

Cost-Benefit Analysis↗
PubMed1994

High-resolution image workstation for intensive care units.

Despite their potential for improving patient management and decreasing costs, picture archiving and communication systems (PACS) are not being absorbed rapidly into clinical practice because of their technical immaturity and because the cost-effectiveness of the technology has not been established. Workstations and archives need to be significantly improved before they can be useful. This report describes the authors' experiences with a high-resolution image workstation for a medical intensive care unit. The workstation has been designed around a standard computer platform and is equipped with two high-resolution image displays. The user interface stresses speed and simplicity. Image manipulation is simplified by providing empirical preset window and level values. Images are displayed in less than 2 seconds. The workstation also displays radiologic reports as soon as they become available. Future work will focus on using the workstation to improve communication between the physician and the radiologist.

Humans↗
PubMed1992

Software suite for image archiving and retrieval.

The efficient operation of a clinical picture archiving and communication system (PACS) requires a fully functional image archive. The archive should not only be able to store and retrieve images reliably but should also work in concert with software that optimizes the flow of image-related information throughout the PACS. The authors devised a software suite that serves to improve the flow and content of information and the integrity of the data. The software was developed by translating the functions performed by a conventional film library. Types of transactions possible with this system include scheduling, canceling, rescheduling, and prestaging examinations; changing demographic information; merging patient information; and generating reports. The authors believe such a software suite is essential for a clinically useful PACS.

Data Display↗
PubMed1990

Magnetic resonance imaging simulator: a teaching tool for radiology.

The increasing use of magnetic resonance imaging (MRI) as a clinical modality has put an enormous burden on medical institutions to cost effectively teach MRI scanning techniques to technologists and physicians. Since MRI scanner time is a scarce resource, it would be ideal if the teaching could be effectively performed off-line. In order to meet this goal, the radiology Department at the University of Pennsylvania has designed and developed a Magnetic Resonance Imaging Simulator. The simulator in its current implementation mimics the General Electric Signa (General Electric Magnetic Resonance Imaging System, Milwaukee, WI) scanner's user interface for image acquisition. The design is general enough to be applied to other MRI scanners. One unique feature of the simulator is its incorporation of an image-synthesis module that permits the user to derive images for any arbitrary combination of pulsing parameters for spin-echo, gradient-echo, and inversion recovery pulse sequences. These images are computed in 5 seconds. The development platform chosen is a standard Apple Macintosh II (Apple Computer, Inc, Cupertino, CA) computer with no specialized hardware peripherals. The user interface is implemented in HyperCard (Apple Computer Inc, Cupertino, CA). All other software development including synthesis and display functions are implemented under the Macintosh Programmer's Workshop 'C' environment. The scan parameters, demographics, and images are tracked using an Oracle (Oracle Corp, Redwood Shores, CA) data base. Images are currently stored on magnetic disk but could be stored on optical media with minimal effort.

Computer Simulation↗
PubMed1989

Induction of cell mediated immune response by nonspecific stimulator of immunity against antigenically unrelated oncogenic virus (Marek's disease virus).

An enzyme treated preparation of Mycobacterium phlei (NSI), induced strong cell mediated immune response (CMIR) against specific as well as against nonspecific oncogenic Marek's disease (MDV) in birds, as evinced by Lymphocyte migration inhibition, (LMIT) lymphocyte transformation test (LT) and Lymphokine (Lymphocyte migration inhibition factor) LyIF assay. Maximum CMIR could be observed towards third week post inoculation. All the three tests exhibited a positive correlation. Such phenomenon of CMIR induction by NSI, nonspecifically to unrelated viral/cancerous diseases (MD) in birds generates hopes for immunoprevention of these maladies by utilizing such phenomenon.

Adjuvants, Immunologic↗
PubMed1989

Nonspecific immunoprotection against Rous sarcoma tumor in chicks.

An enzyme treated preparation of saprophytic Mycobacterium phlei, referred as NSI, when administered intramuscularly has been found to protect the chicks against Rous Sarcoma Virus induced tumor. A protection level of 35.4%, 24.1% and 21.2% were observed when challenged on 10th, 20th and 30th day post NSI inoculation. The tumor growth inhibitory-activity of NSI was significant (P less than 0.01). Both, systemic and intralesional administration of NSI exhibited significant tumorostatic activity (P less than 0.05). NSI stimulated the cell mediated immune response to specific as well as to nonspecific Rous sarcoma antigen. These studies indicated the immunopreventive activity of NSI against Rous sarcoma tumor which had an immunogenic basis.

Adjuvants, Immunologic↗
PubMed1985

Nonspecific immunostimulation against viruses.

A trypsinized preparation from chromogenic selected strain of Mycobacterium phlei (NSI) stimulated the recipient immune system non-specifically against a variety of viruses viz. Rabies virus (RNA virus). Marek's disease (DNA virus) and Foot and Mouth disease virus (RNA virus) in phylogenetically different hosts like mice, chicks and guinea pigs respectively. Investigation into mechanisms of such nonspecific immunostimulation revealed that there was induction of strong cell mediated immune response (CMIR) against both specific as well as to nonspecific viral antigens as evinced by LMIT, lymphokine (LyIF) assay and lymphocyte transformation test etc. There was induction of appreciable quantity of "Infectivity inhibiting substance(s)" (IIS) which was not the classical antibody (Ig) in the serum of NSI inoculated animals and birds. This substance(s) neutralized FMD, IBR, rabies and Newcastle disease virus in cell culture, mice and in embryonated eggs. Electrophoretic separation of the NSI induced serum revealed an increase in beta fraction of globulin.

Adjuvants, Immunologic↗
PubMedDate not supplied

Designing a flexible user interface for both users and programmers.

The design of a user interface for computers is examined from both the end user's and the programmer's point of view. Different methods of menu selection and user feedback are discussed. A graphics interface using pull down menus and dialog boxes is ideal for simplifying user interaction and program organization. This style of interface also provides for a modular program development environment, reduced program development time, program portability, and reduced maintenance. Software tools for programming the user interface are explored and pseudo-code examples are given.

Feedback↗
PubMedDate not supplied

Cellular immunity in chicks expressing fibrosarcomatous liver tumor following embryo infection with subgroup A Rous sarcoma virus.

Bryan standard strain of Rous sarcoma virus (BS-RSV) of subgroup A was inoculated into heavy and light breeds of chicken embryos via chorioallantoic membrane (CAM) to ascertain cell-mediated immune response, as measured by a leukocyte migration inhibition (LMI) test. Chicks hatched from eggs with pock-positive CAMs were more likely to develop liver tumors than those hatched from eggs with pock-negative CAMs. Chicks that developed tumors usually had a positive cell-mediated immune response, and those that were negative for liver tumor were negative, based on the LMI test.

Animals↗
PubMedDate not supplied

Evaluation of cardiac symptoms by trans-telephonic electro-cardiographic monitoring (TTEM): preliminary experience.

Between May 1996 and May 1997, a total of 398 patients (321 males, 77 females) were registered at our institute for trans-telephonic electro-cardiographic monitoring (TTEM). Their age ranged from one month to 95 years. Almost two-third (67%) of patients were from Delhi and one-third (33%) from other places in India and neighbouring countries. Clinical profile of these patients was post-bypass surgery, post-myocardial infarction, chest pain for evaluation, post-percutaneous transluminal coronary angioplasty, chronic stable angina, evaluation of palpitations, arrhythmias, and pace-maker follow-up. Out of 664 symptomatic transmissions, 568 (86%) were received for cardiac symptoms and 96 (14%) for non-cardiac symptoms. Seventy-nine percent patients had chest pain or palpitations at the time of transmission, whereas 21 percent had other symptoms like chest discomfort, breathlessness or dizziness. The electro-cardiograms were transmitted within one hour of the onset of chest pain in 84 percent, palpitations in 78 percent and dizziness in 75 percent. Of patients with symptomatic transmissions, 628 (95%) required either reassurance or drug-dose adjustment and outpatient department review. Only 36 (5%) patients were hospitalised as an emergency, and out of these only 19 (3%) needed acute management. In conclusion, trans-telephonic electro-cardiographic monitoring is a very convenient and an 'all-time-available' monitoring facility for establishing patient-physician contact in the shortest time. It is useful in rendering instant advice for hospitalisation in emergency situations while avoiding unnecessary visits to the hospital.

Adolescent↗
PubMedDate not supplied

Sociomedical problems of aged population in a rural area of Wardha district.

Most of the old persons staying in rural areas are illiterate with physical disabilities and are psychologically disturbed due to the loss of income and hence they are unable to lead a productive life. The present study was thus undertaken in a rural area of Wardha district, with the objective of studying the sociomedical aspects and psychological perceptions of the elderly population. Out of 10,000 population, 600 individuals of age 60 years and above were studied. Proportion of females was 330 (55%) and males 270 (45%) respectively. 300 (66.5%) of them were illiterate, and majority were agricultural labourer (238, 39.66%) and daily labourers (172, 28.66%). 244 individuals (40.67%) were still the head of the family and rest were related to the head of the family. 91 (15.17%) felt the change in attitude of the family members. 139 (31.5%) felt neglected and 146 (24.33%) loneliness respectively.

Aged↗