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Local Solution with Global Potential

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Local Solution with Global Potential

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Local Solution with Global Potential

  1. 1. Development of IT enabled Healthcare Devices and Telemedicine at Dhaka University LOCAL SOLUTION WITH GLOBAL POTENTIAL K Siddique-e Rabbani Department of Biomedical Physics & Technology Dhaka University rabbani@du.ac.bd www.bmpt.du.ac.bd Keynote Presentation, bdNOG4, 11 November2015
  2. 2. Department of Biomedical Physics & Technology
  3. 3. 80% of global population, living in the Third World still remain deprived. Hardly a few % of them, who are rich, get benefit of modern healthcare technology at huge costs Motivation: ECG & X-Ray invented more than 100 years back. How many get the benefits even today?
  4. 4. Our efforts towards indigenous design and Innovation Initially at department of Physics Now at department of Biomedical Physics & Technology (established in 2008, initially offering PhD & Mphil only, now offering Masters programmes in Medical Physics (Radiation related) and Biomedical Engineering
  5. 5. Possibly, the 1st IT enabled Medical Equipment Developed in Bangladesh (1986-1988) Computerised EMG/EP equipment Expertise gained through the UK link First nerve conduction service in Bangladesh (1988) Cost: a fraction of that for imported ones
  6. 6. Recent development: Intra-operative Neuro Monitor To aid brain and Spinal cord surgery Cost: a fraction of that for imported ones
  7. 7. made in Bangladesh Computerised ECG Stand alone, or Online for Telemedicine Made in Bangladesh Cost: a fraction of that for imported ones
  8. 8. Computerised ECG – stand alone/Online for Telemedicine
  9. 9. Computerised ECG Output: Full 12 Lead, diagnostic, pdf file- sent to doctor for report online, even on Smartphone ECG Report Patient Name : null Sex: Female Age: 0 Wednesday 01 July 2015 Patient ID : 1 I II III aVR aVL aVF V1 V2 V3 V4 V5 V6 25 mm/sec 10 mm/mV II 0s 1 s 4s2s 3s 2s 3s 1 s 4s0s 2s0s 4s 1 s 3s 5 mm/mV
  10. 10. Certificate for ECG equipment – received from DMCH Through DG Health of Govt
  11. 11. Dynamic Pedograph Dynamic foot pressure distribution Helps prevent ulcers, leading to Gangrene and foot/leg amputation of diabetic patients Needed in large numbers in the low resource countries
  12. 12. Dynamic Pedograph Our System Main unit goes into a raised platform Cost: a fraction of that for imported ones
  13. 13. Our System gives a black and white picture from which we obtain a colour contour Video: 30 frames per second,
  14. 14. Displays pressure variation with time at 6 selected points
  15. 15. Making Customised Shoe Insoles: Automation possible: Pedograph à CNC machine, or Pedograph à 3D printer
  16. 16. Pedograph Diabetic foot clinic in Baqai Medical University, Karachi, Pakistan (they provided R&D costs)
  17. 17. Our installations of Pedograph 1. Diabetic foot clinic in Baqai Medical University, Karachi, Pakistan + 2 other installations 2. Ibrahim Foot Care Hospital, Dhaka, Bangladesh 3. Leather Research Institute, BCSIR, Bangladesh 4. NIROGI LANKA, Srilanka (Delivery: October 2015)
  18. 18. Semi-functional Hand Prosthesis Partially supported by: • Farm Fresh (Akij Group) (initial phase) • BEXIMCO (Current support)
  19. 19. A simple Prosthetic hand that can write & solder Improvised using a hand of a ‘Mannequin’. Spring loaded thumb only. Cost: about £20. Movie
  20. 20. Cost Effective Myo-electric Prosthetic hand Relaxed – thumb open Contracted – thumb closed Microcontroller Controlled (IT enabled) Presently: Only thumb movement In future: wrist rotation
  21. 21. Focused Impedance Method – Our Innovation Localised Lung function & Respiratory Rate Special challenge: A baby or child should not CRY!! 0.0 0.5 1.0 1.5 2. 0 2.5 3.0 0 30 60 90 120 150 180 Frequency, Hz Rate per min Amplitude,arbitrary scale 10 2 Time, Sec Amplitude,arbitrary scale
  22. 22. FIM for Breast Tumour Characterisation (whether malignant or benign) Cancer Cells have different impedance characteristics than normal Dual Frequency FIM Difficulty: separation from normal tissue around Ht Vt
  23. 23. Feature extraction using IT enabled analysis: Red ones are malignant (through core biopsy) -0.2 0 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 1.8 0 5 10 15 Future/Age(NumericalValue) Feature Number Age Divided Feature Plot P1_Age28 P2_Age52 P3_Age17 P4_Age30 P5_Age40 P6_Age30 P7_Age17 P8_Age24 P9_Age18 P10_Age48 P11_Age32 CP12_Age42 CP13_Age40 CP14_Age55 CP15_Age52 Malignant Benign Patient age range: 17 -55 yrs Unaffected side: Imp: 1-4 Slope: 9, 11 Affected side: Imp: 5-8 Slope: 10, 12 … seems to create some distinction
  24. 24. • Stomach emptying • Stomach acid secretion •Abdominal fat thickness measurement • Bladder emptying •Tumour ablation monitoring ............... many more FIM : potential in Diagnosis and Physiological study
  25. 25. Others starting FIM study: • Warwick University, UK • Kyung Hee University, Korea • University of Oslo, Norway A Swiss R&D company showed interest in developing the equipment for commercialisation, but we did not want take patent, so did not work out
  26. 26. Pigeon Hole Impedance Imaging (PHI) (our concept)
  27. 27. PHI based on 4 electrode FIM. Measurement in every square, gives a low resolution image Z11 Z12 Z13 Z21 Z22 Z23 Z31 Z32 Z33 Z14 Z24 Z34 Z41 Z42 Z43 Z44 I1 I1 v1 I2 I2 v2
  28. 28. PHI simulated experimental results
  29. 29. PHI application Z11 Z12 Z13 Z21 Z22 Z23 Z31 Z32 Z33 Z14 Z24 Z34 Z41 Z42 Z43 Z44
  30. 30. Telemedicine for rural healthcare where qualified doctors are not available
  31. 31. 31 Basic Telemedicine Network
  32. 32. Our developed items for Telemedicine • Digital ECG, 12 lead, full diagnostic • Digital Stethoscope • Digital Microscope • Digital X-Ray view-box • Digital Colposcope (for cervical cancer investigation)
  33. 33. Scheme at Rural/Semi-rural Healthcare Center End Digital Stethoscope Digital X-ray Viewer Digital Microscope Digital Colposcope Digital ECG, 12 Lead Typed data entry through PC keyboard Sound input jack of PC USB port of PC USB port of PC USB port of PC USB port of PC Local PC Telemedicine Software Display Report and Prescription Generation Archiving and Printing INTERNET Video Conferencing
  34. 34. ECG, 12 lead, with live internet transmission For telemedicine
  35. 35. Computerised ECG Output: Full 12 Lead, diagnostic, pdf file- sent to doctor for report online, even on Smartphone ECG Report Patient Name : null Sex: Female Age: 0 Wednesday 01 July 2015 Patient ID : 1 I II III aVR aVL aVF V1 V2 V3 V4 V5 V6 25 mm/sec 10 mm/mV II 0s 1 s 4s2s 3s 2s 3s 1 s 4s0s 2s0s 4s 1 s 3s 5 mm/mV
  36. 36. 36 Improvised Digital Stethoscope A microphone insert is fixed at a cut end of the rubber tube of a commercial stethoscope Delays through internet and limitation of Frequency response does not allow live transmission. => Store & Forward.
  37. 37. Improvised Digital Microscope Software zoom A good webcam attached to a Chinese microscope. We are trying alternative methods using USB camera modules and improvised optics.
  38. 38. 38 Digital X-Ray View Box software zoom
  39. 39. 39 Digital Colposcope for detection of Cervical Cancer Improvised from a binocular Software filtering done to get effects similar to that obtained using Red, Green and Blue filters
  40. 40. 40 Digital Colposcope Software filter - optical
  41. 41. Software for TELEMEDICINE, Web based
  42. 42. Software for TELEMEDICINE: • Registration and ID to health operator and doctor by admin • Log in by remote operator • Log in by doctor • Patient registration, vital information entry and uploading • Doctor sees uploaded data • Patient consults doctor through video consultation. • Real time (almost) stethoscope • Real time (almost) respiration monitor • Real time (almost) ECG • Uploading of images of Ultrasound, X-ray, previous prescriptions A Prescription - preliminary and final • All records archived for future reference <www.bmpt.du.ac.bd/telemedicine>
  43. 43. Prescription generation With database for medicines, advices, etc.
  44. 44. Acknowledgements 1. Farm Fresh brand of Akij group, Bangladesh 2. ISP of Uppsala University, Bangladesh 3. Access to Information programme of Govt of Bangladesh (partners: UNDP, USAID) 4. Information Society Innovation Fund (ISIF)-Asia 5. All post graduate students at the department who contributed to this project
  45. 45. Challenges We want to add Images – Ultrasound Ø 640x480 monochrome adequate Ø Still images , about 100KB, store and forward acceptable Ø Video images, needs 480Kbps for 25 FPS Ø Reducing frame rate to 5FPS in some cases, 120Kbps may be adequate Ø Difficult under present situation Ø We are planning to go for store and forward of Video
  46. 46. Challenges We want to add Images – Ultrasound Ø 640x480 monochrome adequate Ø Still images , about 100KB, store and forward acceptable Ø Video images, needs 480Kbps for 25 FPS Ø Reducing frame rate to 5FPS in some cases, 120Kbps may be adequate Ø Difficult under present situation Ø We are planning to go for store and forward of Video
  47. 47. Dial-up using telephone line : 2.4 Kbps to 56 kbps DSL – Digital Subscriber Line : 16 Kbps to 9 Mbps Broadband Internet Connection, Cable : 200 Kbps to 20 Mbps Fibre optical link : 1 Mbps to 40 Mbps Internet over Satellite : 492 Kbps to 512 Kbps Mobile broadband, 2G : 10 Kbps to 240Kbps Mobile broadband, 3G : 100 Kbps to 16 Mbps Mobile broadband, 4G : 5 Mbps to 1000 Mbps How can you help us in taking these services to remote regions?
  48. 48. How can we deliver the benefits of modern healthcare technology to whole humanity?
  49. 49. University (BMPT) CTE BiBEAT Users, Small entrepreneurs Users, Small entrepreneurs Users,Smallentrepreneurs Users,Smallentrepreneurs 1. BMPT-Dhaka University 2. Centre for Technology Equalisation (CTE) [under Relevant Science & Technology Society, Bangladesh (RSTS)] 3. BiBEAT Ltd. – Company, Limited by Guarantee (under article 29), No shareholders, Paid-up capital: Zero, Nobody takes the profit Model for Dissemination
  50. 50. We have to break away from the existing accepted norm of getting equipment from the rich countries. for global benefit, We are not patenting our products!! Teach technology, manufacture and entrepreneurship to Third World scientists and engineers, ask them to produce the equipment in their own country and sell
  51. 51. Technology innovators should become entrepreneurs Businessmen cannot do this job (wrong concept prevalent now)
  52. 52. All our products are manufactured & sold by BIBEAT Ltd. – a non shareholding company for public good à nobody takes profit (except technologies like safe drinking water for which technology is disseminated at no cost)
  53. 53. Acknowledgements 1. Ministry of Sc & Tech, Govt of Bangladesh 2. Ministry of Education, Govt of Bangladesh 3. Asiatic Society of Bangladesh 4. British ODA (now DFID) 5. University Grants Commission, Bangladesh 6. Neurology Foundation, Bangladesh 7. Trauma Centre, Bangladesh 8. Farm Fresh brand of Akij group, Bangladesh 9. ISP of Uppsala University, Bangladesh 10. Access to Information programme of Govt of Bangladesh (partners: UNDP, USAID) 11. Information Society Innovation Fund (ISIF)-Asia
  54. 54. Our committed and youthful team at the Department of Biomedical Physics & Technology Dhaka University (Includes foreign students)
  55. 55. Thank You

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