classwork: January 2020

6) Open VLC and go to File -> Convert -> Select Audio -> Convert to MP3 and Save/Store (NDHB Blueprint in India accepts MP3 format as standard for sharing audio https://mohfw.gov.in/sites/default/files/National_Digital_Health_Blueprint_Report_comments_invited.pdf )

7) Open Audacity and modify sound for any analysis needed. (Much to explore here for me, will update findings.)

VR ART in EHRs

Project details

https://avi33tbtt.github.io/ArtOfMedicine.html

Live demo

https://avi33tbtt.github.io/DTI%20in%20EHRs/

Medicine is not just Science but also an Art

Where patient present to us as pieces of puzzles sharing the story where we take pieces to join and fit patterns to ones we have already seen

Slowly the pictures stary getting clear and we may reach a diagnosis, there may be uncertainty still and also more complexity possible giving us no clue many times

when we fit and feel to have identified it matching to any that we can proceed with but many times we are clueless but time, placebo and various factors keep playing their role and healing the person, we also try best from what we know and we also discover more from the complexity.

The major part of the art of practice of medicine is not just dealing with uncertainty but more importantly the EMPATHY for patients, understanding them, their needs and their values while also focusing on whole life events to analyse data and find best possible way to help

we are showing a VR based project where womb to tomb EHR data is recorded and along with it various events recorded in artistic way to deliver patient's perspective more clearly and precisely

The Scene in Virtual Reality is interactive and immersive, left the 7 dots show different stages of life and on right, they show different artistic aspects delivering information to the EHR analyst who may be a doctor or an evolved artificial agent.

This is a scene inside the project for a demo purpose showing objectively the measurement on the left and subjectively relevant information on right (in this case art by Rabindranath Tagore)

here are links to various past records https://github.com/avi33tbtt/UDHC-Case-Records-Mirror/wiki/UDHC-RECORDS-MIRROR-PAGE

and all records have discussion on patient-centred problems

where someday when large dataset of many cases and discussions around it will be there, this big data will help us gain better insights and so be able to help better and hopefully will help evolve the AI too for same.

Patient As A Teacher - Resources

Various individual resources arranged in sequence of the video here with links for exploring them in detail.

1) UDHC Citizen Science -

http://classworkdecjan.blogspot.com/2017/11/udhc-citizen-science.html

2) VR ART in EHRs -

https://classworkdecjan.blogspot.com/2020/01/vr-art-in-ehrs.html

3) Data Visualization

https://classworkdecjan.blogspot.com/2017/12/diabetics-data-visualization-queries.html

4) OpenMed App based on UDHC Concept

https://github.com/avi33tbtt/OpenMedApp/blob/master/OpenMed.pdf

5) Obstructive Sleep Apnea Research and Innovation

https://classworkdecjan.blogspot.com/2020/01/obstructive-sleep-apnea-low-cost-device.html

6) Stethoscope Hack

https://classworkdecjan.blogspot.com/2020/01/stethoscope-hack.html

https://www.bmj.com/content/300/6724/573

https://www.ncbi.nlm.nih.gov/pubmed/30323613

User Driven Healthcare Resources

Learning Opportunity

https://promotions.bmj.com/jnl/bmj-case-reports-student-electives-2/

Presentations

http://www.pitt.edu/~super1/lecture/lec50661/001.htm

http://www.pitt.edu/~super1/lecture/lec54101/001.htm

Videos

Kaustav Bera : "User-driven healthcare" @ TEDxEasternMetropolitanBypass

promoting user-driven healthcare and the pivotal role that the evidence that Cochrane has to offer, plays in his work.

BMJ Case Reports Elective

Global Network

https://www.facebook.com/groups/tabularasa

To Join - Contact Avinash Kumar to join -

+918840653960

avi33tbtt@gmail.com

https://www.facebook.com/geekydoctoravi

https://www.linkedin.com/in/geekydoctoravi

Journal

https://www.igi-global.com/journal/international-journal-user-driven-healthcare/41022

Books

https://www.goodreads.com/author/list/3262317.Rakesh_Biswas

Publications

http://scholar.google.com/citations?user=Sc3HgGAAAAAJ&hl=en

Friday 3 January 2020

Obstructive Sleep Apnea - low cost device idea

Obstructive Sleep Apnea

Available solutions-
https://onlinelibrary.wiley.com/doi/full/10.1111/imj.13606

Possible low cost idea-
*alarm for family members if any awake to change patient posture
And/or
*restrict the sleep posture in better suitable
And/or
*make it as a biofeedback device able to bring required postural change in patient. If any such device/system then please inform me at avi33tbtt@gmail.com

Raising pillow on 1 side, the lateral posture (which probably helps to minimize the effect of inner obstruction). central sleep apnea is still a risk but good that its mostly for short duration in rem cycle and not whole night also it happens in normal people and mostly it may not be affecting enough to cause severe hypoxemia.

https://www.atsjournals.org/doi/abs/10.1164/ajrccm.155.1.9001312

In many (obese) patient abdominal compression is highly aggrevating the problems

"Conclusions:

Abdominal compression negatively impacts on UA collapsibility during sleep and this effect may help explain strong associations between central obesity and obstructive sleep apnea."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2786041/

Engineering challenge - reliable biofeedback system for sleeping person (non rem) to change posture early when hypoxemia due to abdominal compression is identified.

Experiment with patient's consent and under treating doctor's guidance and also partnering with patient explaining him what to be done, how to be done, how world can benefit from study possibly.

Details of experiment -> I connected a big pulse-oxymeter device to patient every night for 1 week, he went to sleep and I sat beside him from 9pm to 6am (and also doing some chit chat learning and teaching each other various things, and also had to adjust the device many times in night). I used to continuously look into the device screen without break for whole night to observe patient for understanding the patterns in oxygen saturation variation with sleep apnea attack/episodes. everyday then i used to work in hospital and discuss findings with professor. I have found that its possible to reduce the cost and increase the quality of sleep apnea monitoring, plan better behavioural and lifestyle intervention and hence bring better life to the patient.

Need to do more research on it.