Steganography Based Authenticated Data Sharing in Health Care

As per Health Insurance Portability and Accountability Act (HIPAA)the patient's protection and protection are significant in assurance of medical care protection. Simultaneously, the quantity of maturing populace is developing essentially. Purpose Of-care in medical clinics utilized generally around the globe. The Security Regulations are represented in order to provide data veracity, privacy, and accessibility. Consequently, patient’s ECG along with other physiological signals, for example, temperature, pulse, glucose reading, position, and so forth, were gathered by utilizing Body Sensor Networks (BSNs) and transmitted. At a similar cost, understanding protection is ensured against stalkers while information direct in vulnerable organization and placed in medical clinic workers. Likewise, the accompanying system was consolidated in this venture: (1) encryption and decryption for information classification and trustworthiness (2) ECG based Steganography to trade information. Our plan additionally guarantees security, efficiency, and scalability.

Evaluating the effectiveness of a multi-faceted inpatient diabetes management program among hospitalised patients with diabetes mellitus

Background Diabetes mellitus (DM) is one of the most common chronic diseases. Individuals with DM are more likely to be hospitalised and stay longer than those without DM. Inpatient hypoglycemia and hyperglycemia, which are associated with adverse outcomes, are common, but can be prevented through hospital quality improvement programs. Methods We designed a multi-faceted intervention program with the aim of reducing inpatient hypoglycemia and hyperglycemia. This was implemented over seven phases between September 2013 to January 2016, and covered all the non-critical care wards in a tertiary hospital. The program represented a pragmatic approach that leveraged on existing resources and infrastructure within the hospital. We calculated glucometric outcomes in June to August 2016 and compared them with those in June to August 2013 to assess the overall effectiveness of the program. We used regression models with generalised estimating equations to adjust for potential confounders and account for correlations of repeated outcomes within patients and admissions. Results We observed significant reductions in patient-days affected by hypoglycemia (any glucose reading < 4 mmol/L: OR = 0.71, 95% CI: 0.61 to 0.83, p < 0.001), and hyperglycemia (any glucose reading > 14 mmol/L: OR = 0.84, 95% CI: 0.71 to 0.99, p = 0.041). Similar findings were observed for admission-level hypoglycemia and hyperglycemia. Further analyses suggested that these reductions started to occur four to 6 months post-implementation. Conclusions Our program was associated with sustained improvements in clinically relevant outcomes. Our described intervention could be feasibly implemented by other secondary and tertiary care hospitals by leveraging on existing infrastructure and work force.

Evaluation of TOPS score as predictor for outcome in sick newborns

Background: Multiple parameters have been developed to prognosticate the outcomes of critically ill newborns admitted in NICUs. The objective of this study is to predict the outcome of newborns admitted in NICU using a simple but efficient score, TOPS score, involving alteration of physiological parameters. Aim of this study was to evaluate role of TOPS score in predicting mortality in sick neonates.Methods: The variables assessed under TOPS score on arrival for all subjects were: Temperature, Oxygen Saturation, Perfusion and blood glucose reading <45 mg/dl. All affected neonates were given treatment as per NICU protocol and outcome was assessed in terms of mortality or discharge using TOPS score. It was prospective study conducted at NICU, Department of Pediatrics, GMERS medical college and general hospital, Gotri, Vadodara. Study population was all admitted neonates aged <28 days at NICU.Results: Mean age of presentation of all cases was 2.8±3.58 days. Hypothermia on admission was observed in 63.3% cases. 40.8% cases had hypoxia. 26.5% neonates recorded poor perfusion. Mortality observed in hypoxic group was 51.7% followed by hypothermic group (46.9%). Highest strength of association was found for poor perfusion, mortality (87.5%) and OR-33.406. TOPS score was observed to be statistically significant (X2 value is 63.27, p < 0.05) as predictor of mortality. Thus, mortality rate increased with increasing no. of altered TOPS parameters. Regression analysis showed three factors (hypothermia, hypoxia, prolonged CRT) which are consistently associated with p value ≤ 0.05 for each variable and can be used to predict mortality.Conclusions: All parameters in TOPS score are physiologically important and each parameter carries an independent risk associated with mortality. It is important to note that multiple parameters affected increases the risk. TOPS score is a simple, basic and effective tool to guide about the condition of new born at admission and outcome. of neonatal mortality.

The Rationale for Continuous Glucose Monitoring-based Diabetes Treatment Decisions and Non-adjunctive Continuous Glucose Monitoring Use

Self-monitoring of blood glucose (SMBG) is now recognised as a core component of diabetes self-management. However, there are many limitations to SMBG use in individuals with diabetes who are treated with intensive insulin regimens. Many individuals do not test at the recommended frequencies. Additionally, because SMBG only provides a blood glucose reading at a single point in time, hypoglycaemia and hyperglycaemia can easily go undetected, limiting the user’s ability to take corrective action. Inaccuracies due to user error, environmental factors and weaknesses in SMBG system integrity further limit the utility of SMBG. Real-time continuous glucose monitoring (CGM) displays the current glucose, direction and velocity of glucose change and provides programmable alarms. This trending information and ‘aroundthe- clock’ vigilance provides a significant safety advantage relative to SMBG. No published clinical studies have evaluated outcomes when CGM is used as a replacement for SMBG; however, recent in silico studies support this indication. This article reviews the limitations of SMBG and discusses recent evidence that supports CGM-based decisions as an effective approach to managing insulin-treated diabetes.

Impact of Healthy Life Style on the Patients of Diabetes Mellitus

RESEARCH QUESTION: Impact of healthy life style modification on the patients of diabetes and impaired group STUDY DESIGN: Prospective study design STUDY SETTING: Swarn Jayanti Park and adjacent sector 18 , Indira Nagar, Lucknow STUDY PERIOD: January to June 2010 RESULTS: The results of the analytical findings of the data shows that the fasting glucose reading decreases significantly as the outcome of medication, along with the adoption of healthy life style and the same conclusion is on the impaired group.DOI: http://dx.doi.org/10.3126/jucms.v1i2.8407 Journal of Universal College of Medical Sciences Vol.1(2) 2013: 30-34

The Relationship Between Nonroutine Use of Insulin, Food, and Exercise and the Occurrence of Hypoglycemia in Adults With IDDM and Varying Degrees of Hypoglycemic Awareness and Metabolic Control

The purpose of this study was to determine objectively the relationships between changes in the usual amount of insulin injected, food eaten, and exercise performed, and the subsequent occurrence of low blood glucose (<3.9mM) in adults with IDDM and varying degrees of hypoglycemic awareness and metabolic control. Subjects used a handheld computer to record whether their most recent insulin, food, and exercise had been omitted or were greater than, less than, or about the same as usual following every measured blood glucose level of <3.9mM and >5.6mM. Responses for each self-management behavior were compared for the two blood glucose ranges. Food was omitted more frequently prior to a low glucose reading and exercise was omitted more frequently prior to a high glucose reading. More insulin, less food, and more exercise each were associated with low glucose levels. These findings underscore the importance of traditional diabetes education.

Erroneously High Dextrostix Values Caused by Isopropyl Alcohol

Glucose oxidase peroxidase chromogen reagent (Dextrostix) in combination with the Eyetone colorimeter has become increasingly popular in the rapid detection of hypoglycemic states in the newborn. Although the reliability of this system is well documented, there are several factors which can compromise the accuracy of the procedure. One such problem is the glucose reading given after a blood-alcohol combination is tested. By decreasing the light reflected from the strip, the optical electrical interpretation of the Dextrostix is altered by alcohol such that there is an apparent increase in the glucose level as read by the eyetone meter.