By Dinesh Gannerlla

7/28/2019 By Dinesh Gannerlla

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MINI PROJECT BIOMEDICAL ENGINEERING BVRIT

HOSPITAL TRAINING REPORT

To be submitted

ToCARE HOSPITALS

For partial fulfillment of the requirement for theAward of the Degree

OfBachelor of Technology

In

Bio-medical Engineering

SUBMITED BY

B.S SAI SRIDHAR -07211A1118

Y.MURALI MOHAN -07211A1112

PULIPATI KALYAN -07211A1108

G.DINESH -07211A1105A N M SWAMY -07211A1125

B.HARSHA PRIYA -07211A1106

K.AARTHI -07211A1101

CARE HOSPITALS Page 1


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BIOMEDICAL

INTRODUCTION:

During the last two decades, there have been tremendous advances in the field of

biomedical engineering which have been applied to the medical sciences both for diagnosis and

treatment. As a result of the interaction between these two specialties, a new discipline has

emerged as bio-medical engineering. (Jacob john-1974)

It is unique in the sense that this speciality emerged out of a combination of engineering,

sciences, medicine and biology. (Staewen Williams-1984)

Definition:

Bio medical engineering is defined as that branch of applied science which is

contained with solving and understanding the problems in biology or medicine using principles

methods and approach drawn from engineering science and technology (Richard johns-1975)

Historical aspect of Bio-Medical Engineering:

The field of Medical instrumentation is by no means new. Many instruments were

developed as early as the nineteenth century, for example the ECG was first used by cinthoren

at the end of the century. Progress was slow until after World War II when a surplus of

electronic equipment became available. At that time many technicians and engineers both

within industry and on their own started experiments with and modify existing equipment for

medical use. This progress occurred during the 1950's and the results were after disappointing

for physiological parameters and not measured in the same way as physical parameters. They

also had severe communication problem with the medical profession. During the next decade



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MINI PROJECT BIOMEDICAL ENGINEERING BVRITmany instrument manufactures philosophy was changed equipment analysis and design were

applied directly to medical problems. A large measure of help was provided by the US govt. /in

particular by NASA. The mercury, Gemini and Apollo program needed accurate physiological

monitoring for astronauts, consequently much research and development and money went into

this area.

Some of the concepts of patient monitoring presently used in hospitals through out the

world evolved from the base of astronauts monitoring.

The efficiency of modern medicine not only depends upon the clinical acumen of the

physician but also in optimal utilization of available sophisticated bio medical equipment, and

such equipments need careful attention as well as maintenance without any breakdown or

if/there is a breakdown it should be attended within the shortest possible time. Hence the needfor bio medical engineering depart/arises which has to take up the responsibility of maintenance

equipment.

Since the new technologies are rapidly creeping into the field of medicine. It is essential to

have a Bio Medical Engineering unit attached to a modern hospital which can suggest/ can take

care of planning, organizing, installation, maintenance newly developing biomedical equipment

for rapid diagnosis and treatment of a number of ailments. Equipments from very large range

such as the X-RAY, CT-SCAN, MRI, ULTRASOUND, ECHO, IABP, HEART-LUNG

MACHINE, HOLTER, EEG, EMG, dialysis, PACEMAKER, ANESTHESIA VENTILATORS

DIATHERMIES. Monitors, ventilators, ABG, etc. have to be regularly checked and maintained

by Bio Medical Engineering department. Preventive maintenance is necessary for the proper

operating of equipment but other factors help add to the effectiveness of a good program.

Apart from the BIOMEDICAL department has the greatest responsibility of maintaining

major equipment because of service as well as emergency services, which inturn affect the

patient care. BIOMEDICAL engg dept should also maintain the service record for the major

equipment to meet the urgent requirement and keep the spare parts in stock for ready usage. The

purpose of biomedical engg dept in hospital is to guiding/advising the administration and



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MINI PROJECT BIOMEDICAL ENGINEERING BVRITphysicians about the utility, future developments in the equipment to purchased or already

purchased or conversion of old models to the recent once, extension of the usage of equipment

for different purposes.

RESPONSIBILITIES OF A BIO-MEDICAL ENGINEER:

Attend to emergency breakdown of the essential equipment

To monitor the available equipment on regular base.

To keep stock of the spare parts.

Introducing/briefing the hospital or institute to new technology and new equipment and

how best to utilize the same.

In short it is pre purchase evaluation, planning, acceptance testing, inventory control,

training and maintenance

Preparing and performing the preventive maintenance schedule.

PREVENTIVE MAINTAINANCE: PM is defined in the ASHE manual is to clean

adjust. Check for wear and perhaps replace components that might cause total breakdown

or serious functional impairment of the equipment before the next scheduled inspection

(ASHE) PM will help eliminate hazards before they develop.

The PMprocedure is primarily a performance test to ensure that the equipment

is operating properly and is calibrated. However problems do occur because of deterioration of

equipment caused by normal use and again can be detected prior to their causing a malfunction.

Proper cleaning, Lubrication and repair of replacement of defective parts prior to a serious

malfunction will prolong the useful life of the equipments.



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CONTENTS:

1. NEPHROLOGY: DIALYSIS

2. NEUROLOGY: EEG

3. CARDIOLOGY: HEART - LUNG MACHINE

4. GASTROENTEROLOGY: ENDOSCOPES

5.RADIOLOGY: MRI,CT,X-RAY,ULTRASOUND

6.CSSD

7. OXYGEN PLANT



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NEPHROLOGY

Dialysis:

In medicine, dialysis (from Greek "dialusis", meaning dissolution, "dia", meaning through, and

"lusis", meaning loosening) is primarily used to provide an artificial replacement for lost kidney

function (renal replacement therapy) due to renal failure. Dialysis may be used for very sick

patients who have suddenly but temporarily, lost their kidney function (acute renal failure) or

for quite stable patients who have permanently lost their kidney function (stage 5 chronic

kidney disease). When healthy, the kidneys maintain the body's internal equilibrium of water

and minerals (sodium, potassium, chloride, calcium, phosphorus, magnesium, sulfate) and the

kidneys remove from the blood the daily metabolic load of fixed hydrogen ions. The kidneys

also function as a part of the endocrine system producing erythropoietin and 1,25-

dihydroxycholecalciferol (calcitriol). Dialysis treatments imperfectly replace some of thesefunctions through the diffusion (waste removal) and convection (fluid removal). Dialysis is an

imperfect treatment to replace kidney function because it does not correct the endocrine

functions of the kidney

Principle:

Dialysis works on the principles of the diffusion and osmosis of solutes and fluid across a semi-

permeable membrane. Blood flows by one side of a semi-permeable membrane, and a dialysate

or fluid flows by the opposite side. Smaller solutes and fluid pass through the membrane. The

blood flows in one direction and the dialysate flows in the opposite. The concentrations of



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MINI PROJECT BIOMEDICAL ENGINEERING BVRITundesired solutes (for example potassium, calcium, and urea) are high in the blood, but low or

absent in the dialysis solution and constant replacement of the dialysate ensures that the

concentration of undesired solutes is kept low on this side of the membrane. The dialysis

solution has levels of minerals like potassium and calcium that are similar to their natural

concentration in healthy blood. For another solute, bicarbonate, dialysis solution level is set at a

slightly higher level than in normal blood, to encourage diffusion of bicarbonate into the blood,

to neutralise the metabolic acidosis that is often present in these patients.

Types:

There are two primary types of dialysis, hemodialysis and peritoneal dialysisHemodialysis:

In hemodialysis,

the patient's blood

is pumped through

the bloodcompartment of a

dialyzer, exposing

it to a

semipermeable

membrane. The cleansed blood is then returned via the circuit back to the body. Ultrafiltration

occurs by increasing the hydrostatic pressure across the dialyzer membrane. This usually is

done by applying a negative pressure to the dialysate compartment of the dialyzer. This

pressure gradient causes water and dissolved solutes to move from blood to dialysate, and

allows removal of several litres of excess fluid during a typical 3 to 5 hour treatment. In the US,

hemodialysis treatments are typically given in a dialysis center three times per week (due in the



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MINI PROJECT BIOMEDICAL ENGINEERING BVRITUS to Medicare reimbursement rules), however, as of 2007 over 2,000 people in the US are

dialyzing at home more frequently for various treatment lengths. Studies have demonstrated the

clinical benefits of dialyzing 5 to 7 times a week, for 6 to 8 hours. These frequent long

treatments are often done at home, while sleeping but home dialysis is a flexible modality and

schedules can be changed day to day, week to week. In general, studies have shown that both

increased treatment length and frequency are clinically beneficial

Peritoneal dialysis:

In peritoneal dialysis, a sterile solution containing minerals and glucose is run through a tube

into the peritoneal cavity, the abdominal body cavity around the intestine, where the peritoneal

membrane acts as a semipermeable membrane. The dialysate is left there for a period of time to

absorb waste products, and then it is drained out through the tube and discarded. This cycle or

"exchange" is normally repeated 4-5 times during the day, (sometimes more often overnight

with an automated system). Ultrafiltration occurs via osmosis; the dialysis solution used

contains a high concentration of glucose, and the resulting osmotic pressure causes fluid to

move from the blood into the dialysate. As a result, more fluid is drained than was instilled.



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MINI PROJECT BIOMEDICAL ENGINEERING BVRITPeritoneal dialysis is less efficient than hemodialysis, but because it is carried out for a longer

period of time the net effect in terms of removal of waste products and of salt and water are

similar to hemodialysis. Peritoneal dialysis is carried out at home by the patient and it requires

motivation. Although support is helpful, it is not essential. It does free patients from the routine

of having to go to a dialysis clinic on a fixed schedule multiple times per week, and it can be

done while travelling with a minimum of specialized equipment.

Hemofiltration: Hemofiltration is a similar treatment to hemodialysis, but it makes use of a

different principle. The blood is pumped through a dialyzer or "hemofilter" as in dialysis, but no

dialysate is used. A pressure gradient is applied; as a result, water moves across the very

permeable membrane rapidly, facilitating the transport of dissolved substances, importantly

ones with large molecular weights, which are cleared less well by hemodialysis. Salts and waterlost from the blood during this process are replaced with a "substitution fluid" that is infused

into the extracorporeal circuit during the treatment. Hemodiafiltration is a term used to describe

several methods of combining hemodialysis and hemofiltration in one process

What is dialysis access?

In the context of this article, dialysis access is an

entranceway into your bloodstream that lies completely

beneath your skin and is easy to use. The access is usually in

your arm, but sometimes in the leg, and allows blood to be

removed and returned quickly, efficiently, and safely during

dialysis or, less commonly, for other procedures requiring

frequent access to your circulation. Dialysis, also called

hemodialysis, is the most common treatment for kidney

failure. A dialysis machine is an artificial kidney

designed to remove impurities from your blood. During dialysis, physicians use the dialysis

access to remove a portion of your blood to circulate it through the dialysis machine so it can



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MINI PROJECT BIOMEDICAL ENGINEERING BVRITremove impurities and regulate fluid and chemical balances. The purified blood is then returned

to you, again through the dialysis access.

Creating the access portal is a minor surgical procedure. There are two types of portals placed

completely under the skin:

Fistula, which your vascular surgeon constructs by joining an artery to a vein.

Graft, which is a man-made tube, consisting of a plastic or other material, that your

vascular surgeon inserts under the skin to connect an artery to a vein.

For both fistulas and grafts, the connection between your

artery and vein increases blood flow through the vein. In

response, your vein stretches and becomes strengthened. This

allows an even greater amount of blood to pass through the

vein and allows your dialysis to proceed efficiently. In the

weeks after surgery, the fistula begins to mature. The vein

increases in size and may look like a cord under your skin.

The whole process of maturation, which is a beneficial feature

that permits the blood flow to increase in the fistula, typically

takes 3 to 6 months. Some fistulas may take as long as a year

or more to develop fully, but this is unusual. Once matured, a fistula should be large and strong

enough for dialysis technicians and nurses to insert the large dialysis needles easily. If it fails to

mature in a reasonable period of time, however, you may need another fistula. You can usually

begin using your graft in 2 to 6 weeks, when it is healed sufficiently. Usually fistulas are

preferred to grafts, however, because fistulas are constructed using your own tissue, which is

more durable and resistant to infection than are grafts. However, if your vein is blocked or too

small to use, the graft provides a good alternative.



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How do you prepare?

Before choosing the access site, your surgeon may ask you if you have a history or symptoms of

arm or leg artery disease. Hardening of the arteries, which reduces blood flow to your arms

or legs, often can cause these conditions. Your vascular surgeon will not place a dialysis

access site in an area of the body with reduced circulation because the blood flow will be

insufficient. For this reason, your surgeon usually places dialysis access sites in the arms

rather than in the legs because atherosclerosis is more common in the legs. Your vascular

surgeon may order a blood flow test in your arms and legs, such as an ultrasound exam, or

an x ray, such as a venogram, to determine whether your veins are large enough to use for

a fistula. Sometimes a non-invasive pulse volume recording test is used to evaluate the

flow in your arteries if this issue is a concern to your surgeon. Your vascular surgeon will

give you the necessary instructions you need to follow before the surgery, such as fasting.

Usually, your physician will ask you not to eat or drink anything 8 hours before your

procedure. Your physician will discuss with you whether to reduce or stop any

medications that might increase your risk of bleeding or other complications.

Are you eligible for dialysis access?

If you have chronic kidney failure and need long-term hemodialysis, you may require dialysis

access. You may not be a good candidate for a fistula if your veins are too small or are

scarred from frequent placement of intravenous catheters (thin, flexible tubes inserted into

veins to deliver medicine) or needles to draw blood. In that event, you may be eligible for

a graft access procedure. You also may not be a good candidate for a fistula if your arteries

are severely blocked, although they might be repairable if necessary. Your vascular



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MINI PROJECT BIOMEDICAL ENGINEERING BVRITsurgeon will probably be reluctant to use a graft if you have an ongoing infection since the

graft itself might become infected. If this happens, the infected graft might need to be

removed in order to clear up the infection.

What happens during dialysis access?

Typically you will have the procedure on an outpatient basis. Most often, you will first be

sedated and then your surgeon will numb the area where the fistula or graft will go. In

some cases, your anesthesiologist may give you supplemental sedation or put you to sleep.

Depending upon the quality of your artery and vein, your surgeon will try to construct the

fistula with one incision using the forearm of the arm that you do not use as frequently. For

example, if you're left handed, your physician will place the fistula in your right arm, if

possible. To perform the surgery, your physician joins a large vein under the skin to an

artery nearby. The physician divides your vein and sews it to an opening made in the side

of the artery. As a result, the blood flows down the arteries into the hand, as usual, and also

some of this faster moving blood flows into the veins that lead back to your heart. The

blood that normally traveled in your divided vein goes back to the heart through other

veins, and there is usually plenty of blood remaining in your artery to supply your hand. Ifyou cannot receive a fistula because the vein is too small or blocked, your physician may

construct a graft using a tube of man-made, plastic material. Less commonly, your

physician may also choose to use a piece of a vein from your leg or a section of artery

from a cow as alternative graft materials. Your physician sews the graft to one of your

veins and connects the other end to an artery. Your physician may place the graft material

straight or form a loop under the skin either in your lower arm, upper arm, or less

commonly in your leg.

What can you expect after dialysis access?



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MINI PROJECT BIOMEDICAL ENGINEERING BVRITAfter the operation, you should initially keep the access area raised above your heart to reduce

swelling and pain. Your surgeon may recommend an over-the-counter painkiller to relieve

pain, if necessary. Following the suggestions below will help you keep your new access

site working properly in the weeks after the surgery:

Keep the incision dry for at least 2 days after the procedure and do not soak or scrub the

incision until it has healed.

Avoid lifting more than about 15 pounds or other activities that stress or compress the

access area, such as digging.

Report pain, swelling, or bleeding immediately to your physician, especially if these

symptoms are becoming worse. Some pain or swelling is common and not worrisome if

decreasing, but you should tell your physician if you have bleeding, drainage or a fever

higher than 101 degrees Fahrenheit

You may initially feel some coolness or numbness in the hand with the fistula. These

sensations usually go away in a few weeks as your circulation compensates for the

fistula. However, if these sensations are severe, tell your physician as soon as

possible, because the fistula may be causing too much blood to flow away from your

hand. You should perform exercises to grow and strengthen your fistula, after the pain

from the surgery decreases, to make dialysis faster and easier. Your physician may

recommend squeezing a soft object using the hand on the arm in which the fistula was

placed. Grafts may mature more quickly than fistulas depending upon the size of the

vein to which the graft is initially attached. They sometimes can be ready in 2 to 3

weeks, but many physicians recommend waiting about 4 to 6 weeks before using a

graft. Grafts have disadvantages over fistulas, however. Grafts are more likely than

fistulas to become infected. Also, grafts usually last about 1 to 2 years, which is less

than fistulas, which can often last up to 3 to 7 years. If you care properly for your

graft, however, you can help it last for many years. Sometimes access portals can take



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MINI PROJECT BIOMEDICAL ENGINEERING BVRITweeks or even months until they are ready for dialysis use. Until the portal is ready,

you may have to use a catheter for dialysis.

Are there any complications?

Complications with dialysis access include clotting, narrowing, aneurysm formation in the

access itself, infection, and bleeding.

What can you do to stay healthy?

Protecting the dialysis access is crucial for you. The following tips will help you care for a

fistula or a graft:

Check several times each day to make sure the access is functioning. You should be able

to feel a vibration in the. Your physician or dialysis center staff will show you how to do

this.

Monitor any bleeding after dialysis. If the graft seems to bleed longer than usual from the

needle sites, you should notify your dialysis center staff. Do not carry heavy items with the arm that has the access.

Do not sleep on that arm.

Do not wear any clothing or jewelry that binds that arm.

Do not let anyone draw blood or measure blood pressure from that arm.

Do not allow injections to be given into the fistula or graft.

Keep the site of the fistula or graft clean.

After dialysis, monitor the access for signs of infection, such as swelling or redness.



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Electroencephalography

Electroencephalography (EEG) is the measurement of electrical activity produced by the brain

as recorded from electrodes placed on the scalp.

Just as the activity in a computer can be perceived on multiple different levels, from the activity

of individual transistors to the function of applications, so can the electrical activity of the brain

be described on relatively small to relatively large scales. At one end are action potentials in a

single axon or currents within a single dendrite, and at the other end is the activity measured by

the scalp EEG.

The data measured by the scalp EEG are used for clinical and research purposes. A technique

similar to the EEG is intracranial EEG (icEEG), also referred to as subdural EEG (sdEEG) and

electrocorticography (ECoG). These terms refer to the recording of activity from the surface of

the brain (rather than the scalp). Because of the filtering characteristics of the skull and scalp,

icEEG activity has a much higher spatial resolution than surface EEG.

Source of EEG Activity: Scalp EEG measures summated activity of post-synaptic currents. An

action potential in a pre-synaptic axon causes the release of neurotransmitter into the

synapse. The neurotransmitter diffuses across the synaptic cleft and binds to receptors in apost-synaptic dendrite. The activity of many types of receptors results in a flow of ions into

or out of the dendrite. This results in compensatory currents in the extracellular space. It

is these extracellular currents which are responsible for the generation of EEG voltages.

The EEG is not sensitive to axonal action potentials.



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MINI PROJECT BIOMEDICAL ENGINEERING BVRITWhile it is post-synaptic potentials that generate the EEG signal, it is not possible to determine

the activity within a single dendrite or neuron from the scalp EEG. Rather, surface EEG is

the summation of the synchronous activity of thousands of neurons that have similar

spatial orientation, radial to the scalp. Currents that are tangential to the scalp are not

picked up by the EEG. The EEG therefore benefits from the parallel, radial arrangement

of apical dendrites in the cortex. Because voltage fields fall off with the fourth power of

the radius, activity from deep sources is more difficult to detect than currents near the

skull.Scalp EEG activity is composed of multiple oscillations. These have different

characteristic frequencies, spatial distributions and associations with different states of

brain functioning (such as awake vs. asleep). These oscillations represent synchronized

activity over a network of neurons. The neuronal network underlying some of theseoscillations are understood (such as the thalomocortical resonance underlying sleep

spindles), while many others are not (e.g., the system that generates the posterior basic

rhythm is not yet fully understood).

Method: In conventional scalp EEG, the recording is obtained by placing electrodes on the

scalp with a conductive gel or paste, usually after preparing the scalp area by light abrasion to

reduce impedance due to dead skin cells. The technique has been advanced by the use of carbon

nanotubes to penetrate the outer layers of the skin for improved electrical contact. The sensor is

known as ENOBIO. however, this technique is not in common research or clinical use. Many

systems typically use electrodes, each of which is attached to an individual wire. Some systems

use caps or nets into which electrodes are embedded; this is particularly common when high-

density arrays of electrodes are needed.

Computer ElectroencephalographNeurovisor-BMM 40

http://en.wikipedia.org/wiki/Image:Electroencephalograph_Neurovisor-BMM_40_%28close_view%29.jpg


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MINI PROJECT BIOMEDICAL ENGINEERING BVRITElectrode locations and names are specified by the International 1020 system for most clinical

and research applications (except when high-density arrays are used). This system ensures that

the naming of electrodes is consistent across laboratories. In most clinical applications, 19

recording electrodes (plus ground and system reference) are used. A smaller number of

electrodes are typically used when recording EEG from neonates. Additional electrodes can be

added to the standard set-up when a clinical or research application demands increased spatial

resolution for a particular area of the brain. High-density arrays (typically via cap or net) can

contain up to 256 electrodes more-or-less evenly spaced around the scalp.Each electrode is

connected to one input of a differential amplifier (one amplifier per pair of electrodes); a

common system reference electrode is connected to the other input of each differential

amplifier. These amplifiers amplify the voltage between the active electrode and the reference(typically 1,000100,000 times, or 60100 dB of voltage gain). In analog EEG, the signal is

then filtered (next paragraph), and the EEG signal is output as the deflection of pens as paper

passes underneath. Most EEG systems these days, however, are digital, and the amplified signal

is digitized via an analog-to-digital converter, after being passed through an anti-aliasing filter.

Analog-to-digital sampling typically occurs at 256-512 Hz in clinical scalp EEG; sampling rates

of up to 10 kHz are used in some research applications.The digital EEG signal is stored

electronically and can be filtered for display. Typical settings for the high-pass filter and a low-

pass filter are 0.5-1 Hz and 3570 Hz, respectively. The high-pass filter typically filters out

slow artifact, such as electrogalvanic signals and movement artifact, whereas the low-pass filter

filters out high-frequency artifacts, such as electromyographic signals. An additional notch filter

is typically used to remove artifact caused by electrical power lines (60 Hz in the United States

and 50 Hz in many other countries).As part of an evaluation for epilepsy surgery, it may be

necessary to insert electrodes near the surface of the brain, under the surface of the dura mater.

This is accomplished via burr hole or craniotomy. This is referred to variously as

"electrocorticography (ECoG)", "intracranial EEG (I-EEG)" or "sub-dural EEG (SD-EEG)".

Depth electrodes may also be placed into brain structures, such as the amygdala or



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MINI PROJECT BIOMEDICAL ENGINEERING BVRIThippocampus, structures which are common epileptic foci and may not be "seen" clearly by

scalp EEG. The electrocorticographic signal is processed in the same manner as digial scalp

EEG (above), with a couple of caveats. ECoG is typically recorded at higher sampling rates

than scalp EEG because of the requirements of Nyquist theoremthe sub-dural signal is

composed of a higher predominance of higher frequency components. Also, many of the

artifacts which affect scalp EEG do not impact ECoG, and therefore display filtering is often

not needed.A typical adult human EEG signal is about 10V to 100 V in amplitude when

measured from the scalp and is about 1020 mV when measured from subdural

electrodes.Since an EEG voltage signal represents a difference between the voltages at two

electrodes, the display of the EEG for the reading encephalographer may be set up in one of

several ways. The representation of the EEG channels is referred to as a montage.

Bipolar montage

Each channel (i.e., waveform) represents the difference between two adjacent electrodes.

The entire montage consists of a series of these channels. For example, the channel "Fp1-

F3" represents the difference in voltage between the Fp1 electrode and the F3 electrode.

The next channel in the montage, "F3-C3," represents the voltage difference between F3

and C3, and so on through the entire array of electrodes.

Referential montage

Each channel represents the difference between a certain electrode and a designated

reference electrode. There is no standard position at which this reference is always

placed; it is, however, at a different position than the "recording" electrodes. Midline

positions are often used because they do not amplify the signal in one hemisphere vs. the

other. Another popular reference is "linked ears," which is a physical or mathematicalaverage of electrodes attached to both earlobes or mastoids.

Average reference montage

The outputs of all of the amplifiers are summed and averaged, and this averaged signal is

used as the common reference for each channel.



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MINI PROJECT BIOMEDICAL ENGINEERING BVRITLaplacian montage

Each channel represents the difference between an electrode and a weighted average of

the surrounding electrodes.

Limitations: EEG has several limitations. Most important is its poor spatial resolution. EEG is

most sensitive to a particular set of post-synaptic potentials: those which are generated in

superficial layers of the cortex, on the crests of gyri directly abutting the skull and radial to the

skull. Dendrites which are deeper in the cortex, inside sulci, are in midline or deep structures

(such as the cingulate gyrus or hippocampus) or produce currents which are tangential to the

skull have far less contribution to the EEG signal.The meninges, cerebrospinal fluid and skull

"smear" the EEG signal, obscuring its intracranial source.It is mathematically impossible toreconstruct a unique intercranial current source for a given EEG signal, as some currents

produce potentials that cancel each other out. This is referred to as the inverse problem.

However, much work has been done to produce remarkably good estimates of, at least, a

localized electric dipole that represents the recorded currents.

Advantages: EEG has several strong sides as a tool of exploring brain activity; for

example, its time resolution is very high (on the level of a single millisecond). Other

methods of looking at brain activity, such as PET and MRI have time resolution between

seconds and minutes. EEG measures the brain's electrical activity directly, while other

methods record changes in blood flow (e.g., SPECT, MRI) or metabolic activity (e.g.,

PET), which are indirect markers of brain electrical activity. EEG can be used

simultaneously with MRI so that high-temporal-resolution data can be recorded at the

same time as high-spatial-resolution data, however, since the data derived from each

occurs over a different time course, the data sets do not necessarily represent the exact

same brain activity. There are technical difficulties associated with combining these two

modalities, including the need to remove RF pulse artifact and ballistocardiographic



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MINI PROJECT BIOMEDICAL ENGINEERING BVRITartifact (a results from the movement of pulsed blood) from the EEG. Furthermore,

currents can be induced in moving EEG electrode wires due to the magnetic field of the

MRI.EEG can be recorded at the same time as MEG so that data from these

complimentary high-time-resolution techniques can be combined.

Normal activity: The EEG is typically described in terms of (1) rhythmic activity and (2)

transients. The rhythmic activity is divided into bands by frequency. To some degree, these

frequency bands are a matter of nomenclature (i.e., any rhythmic activity between 8-12 Hz

can be described as "alpha"), but these designations arose because rhythmic activity

within a certain frequency range was noted to have a certain distribution over the scalp or

a certain biological significance.Most of the cerebral signal observed in the scalp EEG

falls in the range of 1-20 Hz (activity below or above this range is likely to be artifactual,

under standard clinical recording techniques).

Comparison table

Comparison of EEG bands

TypeFrequency

(Hz)Location Normally Pathologically

Delta up to 3 frontally in

adults,

posterior in

children;

high

adults slow

wave sleep

in babies

subcortical lesions

diffuse lesions

metabolic

encephalopathy

hydrocephalus



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amplitude

waves

Deep midline

lesions.

Theta 4 - 7 Hz

young

children

drowsiness or

arousal in

older children

and adults

focal subcortical

lesions

metabolic

encephalopathy

deep midline

disorders

some instances of

hydrocephalus

Alpha 8 - 12 Hz

Posterior

regions of

head, both

sides, higher

in amplitude

on dominant

side. Central

sites (c3-c4)

at rest.

Closing the

eyes and by

relaxation.

coma

Beta 12 - 30 Hz both sides,

symmetrical

distribution,

most evident

frontally;

low

amplitude

active, busy or

anxious

thinking,

active

concentration

benzodiazepines



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waves

Gamma 26100

certain

cognitive or

motor

functions

Wave patterns:

Delta is the frequency range up to 3 Hz. It tends to be the highest in amplitude and the

slowest waves. It is seen normally in adults in slow wave sleep. It is also seen normally in

babies. It may occur focally with subcortical lesions and in general distribution with

diffuse lesions, metabolic encephalopathy hydrocephalus or deep midline lesions. It is

usually most prominent frontally in adults (e.g. FIRDA - Frontal Intermittent Rhythmic

Delta) and posteriorly in children e.g. OIRDA - Occipital Intermittent Rhythmic Delta).

Theta is the frequency range from 4 Hz to 7 Hz. Theta is seen normally in young

children. It may be seen in drowsiness or arousal in older children and adults; it can also

be seen in meditation. Excess theta for age represents abnormal activity. It can be seen as

a focal disturbance in focal subcortical lesions; it can be seen in generalized distribution

in diffuse disorder or metabolic encephalopathy or deep midline disorders or some

instances of hydrocephalus.



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Alpha is the frequency range from 8 Hz to 12 Hz. Hans Berger named the first rhythmic

EEG activity he saw, the "alpha wave." This is activity in the 8-12 Hz range seen in the

posterior regions of the head on both sides, being higher in amplitude on the dominant

side. It is brought out by closing the eyes and by relaxation. It was noted to attenuate with

eye opening or mental exertion. This activity is now referred to as "posterior basic

rhythm," the "posterior dominant rhythm" or the "posterior alpha rhythm." The posterior

basic rhythm is actually slower than 8 Hz in young children (therefore technically in the

theta range). In addition to the posterior basic rhythm, there are two other normal alpha

rhythms that are typically discussed: the mu rhythm and a temporal "third rhythm". Alpha

can be abnormal; for example, an EEG that has diffuse alpha occurring in coma and is

not responsive to external stimuli is referred to as "alpha coma".

Mu rhythm is alpha-range activity that is seen over the sensorimotor cortex. It

characteristically attenuates with movement of the contralateral arm (or mental imagery

of movement of the contralateral arm).



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Beta is the frequency range from 12 Hz to about 30 Hz. It is seen usually on both sides in

symmetrical distribution and is most evident frontally. Low amplitude beta with multiple

and varying frequencies is often associated with active, busy or anxious thinking andactive concentration. Rhythmic beta with a dominant set of frequencies is associated with

various pathologies and drug effects, especially benzodiazepines. Activity over about 25

Hz seen in the scalp EEG is rarely cerebral (i.e., it is most often artifactual). It may be

absent or reduced in areas of cortical damage. It is the dominant rhythm in patients who

are alert or anxious or who have their eyes open.

Gamma is the frequency range approximately 26100 Hz. Because of the filtering

properties of the skull and scalp, gamma rhythms can only be recorded from

electrocorticography or possibly with magnetoencephalography. Gamma rhythms are

thought to represent binding of different populations of neurons together into a network

for the purpose of carrying out a certain cognitive or motor function.

HEART LUNG MACHINE

The coronary arteries supply blood to the heart. The most common cause of death for is heart

attack which is usually caused by blockages in arteries. When the condition cannot be

effectively treated with medicines or catheter-based angioplasty and stents(blood flows through



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MINI PROJECT BIOMEDICAL ENGINEERING BVRITstents after opening clogged arteries), a form of open-heart surgery called coronary artery

bypass grafting is recommended which usually takes 3 to 5 hours.. Coronary artery bypass

grafting (CABG) uses arteries and/or veins from other parts of the body to bypass the blocked

coronary arteries on the surface of the heart. This technique and technology make operations

more effective and safer for patients.

Open-Heart Surgery: For Open-Heart surgery, patient is made unconscious and various

parameters like heartbeat, blood pressure, oxygen levels, breathing etc are monitored. A

breathing tube is placed in lungs through throat and connected to a ventilator and surgeon

makes a 6- to 8-inch incision in the center of chest wall. Then the chest bone is cut and rib cage

is opened to access heart. Then a medicine is given to thin blood and keeps it from clotting. A

heart-lung bypass machine is connected to heart and takes over for heart by replacing the heart's

pumping action. The bypass machine allows the surgeon to operate on a heart that isn't moving

and full of blood. Then medicines are given to stop the heartbeat once patient is connected to

the heart-lung machine. A pipe is placed in heart to drain blood to the machine which removes

carbon dioxide from blood, & adds oxygen, and then pumps the blood back into body. Tubes

are then inserted into chest to drain fluid. Once the machine begins to work, the surgeon

performs the surgery to repair heart problem.

http://en.wikipedia.org/wiki/Image:PTCA_stent_NIH.gif


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At the end of the surgery, heart is restarted using mild electric shocks. The pipes and tubes are

removed from heart, and the heart-lung machine is stopped. Then again a medicine is given to

allow the blood to clot and chest bone is closed with wires. Stitches or staples are used to close

the incision. The breathing tube is removed. An advantage of open-heart surgery is that it's

easier for the surgeon to operate for long and complex surgeries.

Applications: Heart surgery is done to repair or replace valves that control blood flow through

the heart, repair structures in the heart, implant devices to regulate heart rhythms, or replace a

damaged heart with a healthy heart from a donor, bypass blocked arteries, treat arrhythmiasrepairaneurysms, treat angina (chest pain or discomfort) etc.

Sarns 8000 Heart Lung Machine: Cardiothoracic surgical program is the most important goal

of open-heart program. The Sarns 8000 is a modular heart lung machine that is available in a

variety of configurations. It has 4 pumps units that are available with built-in centrifugal pump

and power input is 220-240VAC, 50Hz,/440 V 3 Phase as appropriate fitted.

http://www.nhlbi.nih.gov/health/dci/Diseases/arr/arr_whatis.htmlhttp://www.nhlbi.nih.gov/health/dci/Diseases/arm/arm_what.htmlhttp://www.nhlbi.nih.gov/health/dci/Diseases/Angina/Angina_WhatIs.htmlhttp://www.nhlbi.nih.gov/health/dci/Diseases/arr/arr_whatis.htmlhttp://www.nhlbi.nih.gov/health/dci/Diseases/arm/arm_what.htmlhttp://www.nhlbi.nih.gov/health/dci/Diseases/Angina/Angina_WhatIs.html


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Equipment consist of following :

5- Pump Console

Temperature Control Module (Hypo-Hyper thermia unit)

Monitors: a) Pressure monitor arterial and cardioplegia with transducers

b) Time

c) Temperature Monitor with probes

d) Display of total volume of each infusion with delivery time

Air- Oxygen Blender with hoses and Flow meter

Safety Devices

Ultrasonic air sensor

Level Sensor

Technical Specifications:

A. 5- Pump Console:

1. It has 5-pump console compactly arranged with separate power supply and control modules

with easy access connectors for interchanging the pump.

2. Each individual roller pump is capable of running independently on 220 V/50Hz supply

with a spill proof base. The unit is supplied with a Battery backup for at least two pumps

& all safety systems for a minimum of 15 minutes. Switch over from main power to battery

backup is automatic and immediate.



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MINI PROJECT BIOMEDICAL ENGINEERING BVRIT3. Individual pump heads have Harvey Roller pumps with facility for tubing to be used

adjustable from to 5/8 through 3/8 & by easily changeable mechanism. The total

infusion volume in litres and delivery time, the flow rates in LPM and in RPM.

4. Each Pump has easy mechanism for occlusion setting for different thickness of tubes with

unidirectional hand crank facility as a critical safety feature.

5. The Console has a compact base mount for the entire pump heads together, with pole and

handles and variable, changeable tubing holders in each pump head.

6. It has a movable oxygenator holder and roller pump has a self diagnostic circuit with

provision to detect and display critical alarm conditions and optional pulsatile module

which can be mounted on any of the blood pump.

7. It has a venous control module with single pole mast with electronic venous line occluder,a monitor mount with adjustable monitoring arm and an instrument tray positionable with

long monitoring arm.

B. Temperature Control Module: Temperature control and monitor system with Cardioplegia

supply and remote temperature display has following features:

1. Simultaneous delivery of water for arterial and cardioplegia heat exchangers and to

thermal blankets and works with a power supply of 220 20 V 50 Hz.

2. Pressure regulated blanket ports maintain the temperature of arterial port with

temperature display range of 0- 50 Celsius and remote accuracy of 0.3 Celsius.

3. Microprocessor based unit control, cool, rewarm and maintains temperature. Water outlet

temperature of heat exchanger and blanket range 0-42 C.

4. Maximum flow performance of heat exchanger port 15 22 LPM; 480mmHg maximum

pressure; Blanket 1.5 to 2.5 LPM at zero head.5. Ice generation and rewarming facility with venous difference mode settable at 6 to 10 C

gradients to hold the water bath at higher than venous blood temperature.



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6. Temperature probe module for the operating ranges of 0-50 C. and temperature probes

to fit in standard oxygenators (bubble / membrane).

C. Monitors: They have optional capability for computer interface to retrieve perfusion data.

1. Pressure Monitor: It can monitor one arterial line pressure and two cardioplegia line

pressures (total 3); along with necessary pressure transducers, cables and domes reusable,

with accurate digital display and alarms.

2. Time Monitor: 4 time displays -- 2 for arterial and 2 for cardioplegia delivery with stop,

reset and start function.

3. Temperature: 6 displays- 3 for patient monitoring & 3 for cardioplegia monitoring with

digital display in Celsius with 6 necessary compatible temperature probes with 3 of them

for nasal, rectal and esophageal use.

D. Air-Oxygen Blender: Works at 50-60 PSI for membrane oxygenator with water trap

attached with hoses & connections of min. of 5 meters length and triple flow glass flow meters.

E. Safety and monitoring devices:

1. Ultrasonic Air Sensor: It detect bubbles to work equally well with crystalloid and blood

and can fit anywhere in the circuit easily.

2. Level Sensor System: Ultrasonic transducers to work well with crystalloid and blood

with adhesive pads & with alarm settings.

F. Environmental factors:

The unit is capable of operating continuously in ambient temperature of 10 -400 C and relative

humidity of 15-90% and is capable of being stored continuously in ambient temperature of 0

-500 C and relative humidity of 15-90% with general requirements of safety for Electromagnetic

Compatibility.



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VENTRICULAR ASSIST DEVICES

Ventricular assist devices are innovative external pumps that temporarily support the circulation

inpatients who are believed to have reversible heart failure or who are candidates for heart

transplantation. The Cardiothoracic Surgeons use the Abiomed BVS 5000 Blood Pump, which

can take over pumping action for the right, left, or both ventricles. Ventricular assist devices are

used relatively rarely and are very expensive for the hospital, but are mandatory for any

comprehensive cardiac program. They provide support for prolonged heart recovery and, in

addition, can be an effective bridge to further therapy including transplantation.



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ENDOSCOPE

INTRODUCTION:

Endoscopy is a minimally invasive diagnostic medical procedure that uses tube like instruments

(called endoscopes) to assess interior surfaces of an organ. This procedure is different from

imaging tests, such as X-Rays, which also look inside of the body but usually do not place

instruments inside the body.

An endoscope is a device that uses fibre optics and powerful lens system s to provide lighting

and visualization of the interior of a joint. The portion of the endoscopes inserted into the body

may be rigid or flexible, depending upon the medical procedure. The rigid or flexible tube not

only provide an image for visual inspection and photography, but also enable taking biopsies

and retrieval o foreign objects.

Endoscopes uses two fibre optic lines. A light fibre carries light into the body cavity and an

image fibre carries the image of the body cavity back to the physicians viewing lens. There is

also a separate port to allow for administration of drugs, suction, and irrigation. This port may

also be used to introduce small folding instruments such as forceps, scissors, brushes, snares

and baskets for tissue incision (removal), sampling or other diagnostic and therapeutic work.

Endoscopes may be used in conjunction with a camera or video recorder to document images of

the inside of the joint or chronicle an endoscopic procedure. New endoscopes have digital

capabilities for manipulating and enhancing the video images.



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MINI PROJECT BIOMEDICAL ENGINEERING BVRITMany endoscopic procedures are considered to be relatively painless and, at worst, associated

with mild discomfort; for eg. As in esophagogastroduodenoscopy, most patients tolerate the

procedure with only topical anaesthesia of the oropharynx using lignocaine spray

Complications are not common (only 5% of all operations ) but can include perforation of the

organ under inspection with the endoscope or biopsy instrument. If that occurs open surgery

may be required to repair the injury

ENDOSCOPE

There are many different kinds of endoscopes, or scopes. Some are hollow, allowing the

doctor to see directly into the body, while others use fibre optic (flexible glass or plastic fibers

that transmit light). Still others have small video camera on some endoscopes are stiff while

others are flexible. Endoscopes also vary in length. Each type is specially designed for looking

at a different part of the body. Depending on the area of the body being looked at, the

endoscope may be inserted through an opening like the mouth, anus, or urethra. In some cases,

endoscope is inserted through small incision.

TYPES OF ENDOSCOPES:

Type of Endoscope Inserted into or

through

Body area

Examined

Name of procedures

Bronchoscope mouth or nose Trachea

(windpipe) and

bronchi (tubes

inside the lungs)

Bronchoscopy,

flexible

bronchoscopy

Colonoscope Anus Colon (large

intestine)

Colonoscopy, lower

endoscopy



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Cystoscope Urethra Urinary bladder Cystoscopy,

cystourethroscopy

Esophagogastroduode-

noscope

Mouth Esophagus,

stomach and

duodenum

Esophagogastro-

uodenoscopy (EGD),

panendoscopy,

upper endoscopy

gastroscopy

Hysteroscope Vagina Inside of uterus Hysteroscopy

Laproscope Incision in

abdomen

Space inside

abdomen and

pelvis

Laproscopy,

peritoneal endoscopy

Laryngoscope Mouth or nose Larynx (voice

box)

Layngoscopy

Mediastinoscope Incision above

sternum (breast

bone)

Mediastinum

(space between

lungs)

Mediastinoscopy

Sigmoidoscope Anus Rectum and

sigmoid colon

Sigmoidoscopy,

flexible



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(lower part of

large intestine)

sigmoidoscopy,

proctosigmoidoscopy

Thoracoscope Incision Space between

lungs and chest

wall

Thoracoscopy,

pleuroscopy

Gastroscopy viewing of the stomach. Used to check for ulcers, bleeding or tumours.

Colonoscopy and Sigmoidoscopy viewing of the colon. Used to check for tumours or

polyps (small growths).

Bronchoscopy viewing of the airways and lung tissue. Used to remove foreign bodies,

take samples to diagnose lung cancer or other lung diseases and to assess the condition of

the airways following smoke inhalation.

Cystoscopy viewing of the bladder. Used to check for tumors, stones and other

abnormalities.

Hysteroscopy viewing of the uterus. Used to check for adhesions or polyps and to

investigate excessive menstrual bleeding.

In other types of endoscopy, the skin is opened to allow the scope to enter an area:

Arthroscopy to look into a joint such as the knee. Used to check for torn ligaments or

damaged cartilage.



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MINI PROJECT BIOMEDICAL ENGINEERING BVRITmicroscope or tested in other ways to know for sure whether or not cancer is present. A biopsy

is the best way to find out if a growth is cancer or something else.

In some cases endoscopes are used to help find out how far a cancer may have spread.

Thoracoscopy and laparoscopy can be especially useful in finding out whether certain cancershave spread into one of the body cavities (thorax or abdomen). They let the surgeon look at

these spaces without making a large incision in the skin.

Some types of endoscopy can help make imaging tests more accurate. This can e especially

helpful when trying to find the stage (extent) of cancer within the body. Most people are

familiar with ultrasound, an imaging test in which a transducer is moved over the skin. It sends

sound waves into the body, which bounce back in a pattern that creates an image of the inside

of the body.

ENDOSCOPIC ULTRASOUND (ESU) is a procedure in which a small transducer on the tip of

an endoscope is inserted into the mouth or rectum. By putting the transducer on the tip of the

endoscope, it can get closer to the area where the tumor is to take pictures. It is used to get

information about problems in the digestive tract and surrounding organs. Because the

transducer is close to the organ being studied, it can make very detailed pictures. EUS can be

used to see how deeply a tumor may have penetrated into the rectum or esophagus, or into an

organ like the pancreas. It can also help show whether certain lymph nodes are enlarged. EUS

can also help a doctor guide a needle into a lymph node or other suspicious area to do biopsy.



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TREATING CANCER:

Endoscopes can be used to remove or destroy small cancers. Small instruments passed through

an endoscope can be used to cut out small growths. Some forms of endoscopy allow doctors to

use a cautery or laser through the tip of the endoscope to burn or vaporize growths.

Over the last decade or so, a wide variety of endoscopic tools have been developed that allow

doctors to perform minimally invasive surgery. This type of surgery is sometimes called

keyhole surgery or when used for the abdomen, is called laparoscopic surgery. Instead of

using one long surgical incision, it involves making several small incisions in the skin usually inthe chest or abdomen. Long, thin instruments are then inserted through the holes to reach the

inside of the body. A video endoscope is placed through one of the holes to allow the surgeon to

see inside during the operation.

This type of surgery was first used for fairly minor procedures such as gall bladder removal, but

in recent years have begun using it to treat some types of cancer. It is also used to treat early

cancers of the lung, colon, prostate, and some other organs.

There are pros and cons to keyhole surgeries. There is generally less blood loss during the

operation, and patients often recover faster and with less pain because the incisions are smaller

than in regular surgery. Some forms of keyhole surgery use robotic arms, which a surgeon

controls from a console. This technique allows for better magnification of the area and more

precision in working with the delicate surgical instruments.



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MINI PROJECT BIOMEDICAL ENGINEERING BVRITAFTER THE ENDOSCOPY PROCEDURE:

After the procedure the patient will be observed and monitored by a qualified individual in the

endoscopy or a recovery area until a significant portion of the medication has worn off

Occasionally a patient is left with a mild sore throat, which promptly responds to saline gargles

or a feeling of distention from the insufflated air that was used during the procedure. Both

problems are mild and fleeting. When fully recovered, the patient will be instructed when to

resume his/her usual diet (probably within a few hours) and will be allowed to be taken home.

Because of the use of sedation, most facilities mandate that the patient is taken home by another

person and not to drive on his/her own or handle machinery for the remainder of the day.

RISKS

Infection

Punctured organs

Allergic reactions due to Contrast agents or dyes (such as those used in a CT scan)

Over-sedation

COMPONENTS OF ENDOSCOPE:

http://en.wikipedia.org/wiki/Image:Am_ulcer.gif


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MINI PROJECT BIOMEDICAL ENGINEERING BVRITAn endoscope can consist of

a rigid or flexible tube

A light delivery system to illuminate the organ or object under inspection. The light

source is normally outside the body and the light is typically directed via an optical fibresystem

a lens system transmitting the image to the viewer from the fiberscope

an additional channel to allow entry of medical instruments or manipulators

DISTAL END PART OF ENDOSCOPE

A distal end part of an endoscope including an end cap provided with a nozzle for spouting a

fluid in a predetermined direction. The end cap is detachable with respect to a distal end block

which is provided at the distal end of an insert part of the endoscope. Engagement portions are

provided on the end cap and the distal end block to regulate the condition in which the end cap

is fitted to the distal end block. The engagement portion of the end cap and the engagement

portion of the distal end block are formed such that, among different models of endoscopes in

which the distal end blocks have approximately the same outer diameter, the engagementportion of the end cap off one model cannot be engaged with



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MINI PROJECT BIOMEDICAL ENGINEERING BVRITA system of different models of endoscopes, each endoscope having a distal end part, each

distal end part comprising:

an end cap provided with a nozzle for spouting a fluid in a predetermined direction, said end

cap being detachable with respect to a distal end block which is provided at a distal end of an

insert part of an endoscope; and

engagement means provided on said end cap and said distal end block to regulate a condition in

which said end cap is fitted to said distal end block, said engagement means including mating

portions which are engageable with each other, said mating portions also positioning the end

cap with respect to said distal end block in a direction of rotation,

said engagement means provided on said end cap and said engagement means provided on said

distal end block being formed such that, among said different models of endoscopes in said

system in which distal end blocks have approximately the same outer diameter, said

engagement means provided on said end cap of one model cannot be engaged with said

engagement means provided on said distal end block of another model.

Distal endoscope part having light emitting source such as light emitting diodes as

illuminating means

A substrate having a plurality of light emitting diodes united therewith lies on a plane

containing the longitudinal axis of an insertion unit of an endoscope and its neighborhood.

Likewise, part of a first objective surface lies on the plane containing the longitudinal axis of

the insertion unit of the endoscope and its neighborhood. As long as the diameter of the

insertion unit remains unchanged, the plane containing the longitudinal axis of the insertion unit

of the endoscope and its neighborhood provides the largest area for the light emitting diodes.



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MINI PROJECT BIOMEDICAL ENGINEERING BVRITThe light emitting diode sub-assembly is therefore placed on the plane, whereby the outer

diameter of a distal endoscope part can be made as small as possible.

BRONCHOSCOPE

BRONCHOSCOPY is a medical procedure where a tube is inserted into the airways, usually

through the nose or mouth. This allows the practitioner to examine inside a patients airway for

abnormalities such as foreign bodies, bleeding, tumors, or inflammation. The practitioner often

takes samples from inside the lungs: biopsies, fluid (bronchoalveolar lavage), or endobronchial

brushing. The practitioner may use either a rigid bronchoscope or flexible bronchoscope.



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Rigid Bronchoscopy:

A rigid bronchoscope is a straight, hollow, metal tube. Doctors perform rigid bronchoscopy less

often today, but it remains the procedure of choice for removing foreign materials, as its

increased thickness allows instruments to be more easily inserted through it. Rigid

bronchoscopy also becomes useful when bleeding interferes with viewing the examining area

and allows for more interventions, such as cautery to stop the bleeding.

Flexible Bronchoscopy:

A flexible bronchoscope is a long tube that contains small clear optical fibers that transmit light

images as the tube bends. Its flexibility allows this instrument to reach further into the airway.

The procedure can be performed easily and safely under local anesthesia. As flexible

bronchoscopes become more advanced, it is likely that they will replace rigid bronchoscopes for

most procedures.



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GASTROSCOPE

GASTROSCOPY is an examination of the inside of the gullet, stomach and duodenum. It is

performed by using a thin, flexible fibre optic instrument that is passed through the mouth and

allows the doctor to see whether there is any damage to the lining of the oesophagus (gullet) or

stomach, and whether there are any ulcers in the stomach or duodenum.

Gastroscope

The gastroscope is a flexible plastic tube approximately four feet long and one half inch wide

The gastroscope contains optic fibers with a light source that allow the gastroscope to function

like a video camera.



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MINI PROJECT BIOMEDICAL ENGINEERING BVRITThe use of the gastroscope is esophagogastroduodenoscopy or EGD. An EGD is done when the

doctor suspects that there is a problem with the swallowing tube, stomach, or small intestine. In

the ICU, the two most common reasons for the using the gastroscope are to evaluate a patient

suspected of bleeding from the stomach or intestines and to help place a gastrostomy tube.

Occasionally, a special gastroscope is used for patients who may have an inflamed pancreas or

blocked gallbladder drainage system.



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RADIOLOGY

MAGNETIC RESONANCE IMAGING

Medical Imaging has created a revolutionary change in the field of medicine, the imaging of the

human body is very much useful in determining the diseases and used for all the treatments.

The magnetic resonance phenomenon can be described by both classical and quantum

mechanical approaches. Magnetic resonance imaging is based on the techniques of nuclear

magnetic resonance. MRI scanner uses powerful magnets to polarize and excite hydrogen

nuclei (singleproton) in water molecules in human tissue, producing a detectable signal which

is spatially encoded resulting in images of the body. MRI involves the use of three kinds of

electromagnetic field: Avery strong (of the order of units of teslas) static magnetic field to

polarize the hydrogen nuclei, called the static field, A weaker time-varying (of the order of 1

kHz) for spatial encoding, called the gradient fields, A weak radio-frequency (RF) field for

manipulation of the hydrogen.

The scanner first aligns the nuclear spins of hydrogen atoms in the patient and starts rotating

them in a perfect concert. The nuclei emit maximum-strength electromagnetic waves at the

start, but over time the rotating spins get out of synch, simply due to small differences in localmagnetic fields. The unsynchronized spins cause the combined electromagnetic signal to decay

with time, a phenomenon called relaxation. A slice is selected applying a gradient in a particular

direction (X, YorZ). Magnetic resonance signals are then formed by means of the application of

magnetic field gradients along three different directions. Finally, the signals are acquired and

Fourier transformed to form a two-dimensional or three-dimensional image.

MRI Construction and operation

http://en.wikipedia.org/w/index.php?title=MRI_scanner&action=edithttp://en.wikipedia.org/wiki/Hydrogenhttp://en.wikipedia.org/wiki/Protonhttp://en.wikipedia.org/wiki/Electromagnetic_fieldhttp://en.wikipedia.org/wiki/Tesla_(unit)http://en.wikipedia.org/wiki/Radio-frequencyhttp://en.wikipedia.org/wiki/RFhttp://en.wikipedia.org/w/index.php?title=MRI_scanner&action=edithttp://en.wikipedia.org/wiki/Hydrogenhttp://en.wikipedia.org/wiki/Protonhttp://en.wikipedia.org/wiki/Electromagnetic_fieldhttp://en.wikipedia.org/wiki/Tesla_(unit)http://en.wikipedia.org/wiki/Radio-frequencyhttp://en.wikipedia.org/wiki/RF


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Magnet: The imaging magnet is the most expensive component of the magnetic resonance

imaging system. Most magnets are of the superconducting type. A superconducting magnet is

an electromagnet made of superconducting wire. Superconducting wire has a resistance

approximately equal to zero when it is cooled to a temperature close to absolute zero (-273.15 o

C or 0 K) by immersing it in liquid helium. Once current is caused to flow in the coil it will

continue to flow as long as the coil is kept at liquid helium temperatures. The length of

superconducting wire in the magnet is typically several miles. The coil of wire is kept at a

temperature of 4.2K by immersing it in liquid helium. The coil and liquid helium is kept in a

large dewar. The typical volume of liquid Helium in an MRI magnet is 1700 liters. In early

magnet designs, this dewar was typically surrounded by a liquid nitrogen (77.4K) dewar which

acts as a thermal buffer between the room temperature (293K) and the liquid helium. In later

magnet designs, the liquid nitrogen region was replaced by a dewar cooled by a refrigerator.

This design eliminates the need to add liquid nitrogen to the magnet. It is expected that

cryocoolers for the helium reservoir will soon be available



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MINI PROJECT BIOMEDICAL ENGINEERING BVRITAn imaging coil must resonate, or efficiently store energy, at the Larmor frequency. All

imaging coils are composed of an inductor, or inductive elements, and a set of capacitive

elements. The resonant frequency, of an RF coil is determined by the inductance (L) and

capacitance (C) of the inductor capacitor circuit.

.

RF Coil for 4.7T Magnet

There are many types of imaging coils. Volume coils surround the imaged object while surface

coils are placed adjacent to the imaged object. An internal coil is one designed to record

information from regions outside of the coil, such as a catheter coil designed to be inserted into

a blood vessel. Some coils can operate as both the transmitter of the B 1 field and the receiver of

the RF signal. Other coils are designed as only the receiver of the RF signal. When a receive

only coil is used, a larger coil on the imager is used as the transmitter of RF energy to producing

the 90o and 180o pulses.



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Slice selection

A single frequency RF pulse is applied to the whole sample; only a narrow plane perpendicular

to the longitudinal axis at the centre of the sample will absorb the RF energy. Everywhere else

in the sample is receiving the wrong frequency of excitation for resonance to occur. This

technique allows a slice, with thickness determined by the magnetic field gradient strength, to

be selected from a sample.

Technical Specifications

Tim

Up to 76 seamlessly integrated coil elements with up to 18 RF channels

205 cm FoV. Whole Body

PAT. Unlimited

Workflow automation

Examples are: Phoenix, Auto Align, Inline Technology

Compact magnet

Ultra compact 1.5T magnet (length: 120 cm)

Wide, patient-friendly inner bore diameter (70 cm)

Magnet weight including Helium only approx. 3,800 kg

Unique CT-like 70 cm Open Bore diameter, with high homogeneity over 30 cm



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Computer

syngo-speaking user interface syngo is the common software platform for all imaging

modalities. Enhanced productivity with minimized user interactions per operation step. Based

on a powerful Pentium 4/3 GHz Panoramic Recon Image Processor reconstructing up to 3,226

images per second (256 x 256, 25% recFoV) in combination with a Pentium 4-based Host

Computer with two CPUs/3 GHz and 2 GB RAM capacity.

Cost-effective siting

30 qm/325 sq. ft. floor space only

No computer room required for a total of just two electronic cabinets (water-cooled).

Computer tomography(ct scan)

CT scanningsometimes called CAT scanningis a noninvasive medical test that helps

physicians diagnose and treat medical conditions.

CT scanning combines special x-ray equipment with sophisticated computers to produce

multiple images or pictures of the inside of the body. These cross-sectional images of the areabeing studied can then be examined on a computer monitor, printed or transferred to a CD.

CT scans of internal organs, bones, soft tissue and blood vessels provide greater clarity and

reveal more details than regular x-ray exams.

Using specialized equipment and expertise to create and interpret CT scans of the

body, radiologists can more easily diagnose problems such as cancers, cardiovascular disease,

infectious disease, appendicitis, trauma and musculoskeletal disorders.

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CT-SCAN MACHINE

The CT scanner is typically a large, box like machine with a hole, or short tunnel, in the center.

You will lie on a narrow examination table that slides into and out of this tunnel. Rotating

around you, the x-ray tube and electronic x-ray detectors are located opposite each other in a

ring, called a gantry. The computer workstation that processes the imaging information is

located in a separate room, where the technologist operates the scanner and monitors your

examination.



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MINI PROJECT BIOMEDICAL ENGINEERING BVRITIn many ways CT scanning works very much like other x-ray examinations. X-rays are a form

of radiationlike light or radio wavesthat can be directed at the body. Different body parts

absorb the x-rays in varying degrees.

In a conventional x-ray exam, a small burst of radiation is aimed at and passes through the

body, recording an image on photographic film or a special image recording plate. Bones

appear white on the x-ray; soft tissue shows up in shades of gray and air appears black.

With CT scanning, numerous x-ray beams and a set of electronic x-ray detectors rotate aroundyou, measuring the amount of radiation being absorbed throughout your body. At the same

time, the examination table is moving through the scanner, so that the x-ray beam follows a

spiral path. A special computer program processes this large volume of data to create two-

dimensional cross-sectional images of your body, which are then displayed on a monitor. This

technique is called helical or spiral CT.

CT imaging is sometimes compared to looking into a loaf of bread by cutting the loaf into thin

slices. When the image slices are reassembled by computer software, the result is a very

detailed multidimensional view of the body's interior.

Refinements in detector technology allow new CT scanners to obtain multiple slices in a singlerotation. These scanners, called "multislice CT" or "multidetector CT," allow thinner slices to

be obtained in a shorter period of time, resulting in more detail and additional view capabilities.

BENEFITS AND RISKS OF CT-SCAN

Benefits

CT scanning is painless, noninvasive and accurate.

A major advantage of CT is its ability to image bone, soft tissue and blood vessels all at the

same time.

Unlike conventional x-rays, CT scanning provides very detailed images of many types of

tissue as well as the lungs, bones, and blood vessels.

CT examinations are fast and simple; in emergency cases, they can reveal internal injuries

and bleeding quickly enough to help save lives.

CT has been shown to be a cost-effective imaging tool for a wide range of clinical

problems.

CT is less sensitive to patient movement than MRI.

CT can be performed if you have an implanted medical device of any kind, unlike MRI. A diagnosis determined by CT scanning may eliminate the need for exploratory surgery and

surgical biopsy.

No radiation remains in a patient's body after a CT examination.

X-rays used in CT scans usually have no immediate side effects.



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The equipment typically used for bone x-rays consists of an x-ray tube suspended over a table

on which the patient lies. A drawer under the table holds the x-ray film orimage recording

plate. Sometimes the x-ray is taken with the patient standing upright, as in cases of knee x-rays.

A portable x-ray machine is a compact apparatus that can be taken to the patient in a hospital

bed or the emergency room. The x-ray tube is connected to a flexible arm that is extended over

the patient while an x-ray film holder or image recording plate is placed beneath the patient.

PROCEDURE

X-rays are a form of radiation like light or radio waves. X-rays pass through most objects,

including the body. Once it is carefully aimed at the part of the body being examined, an x-ray

machine produces a small burst of radiation that passes through the body, recording an image

on photographic film or a special digital image recording plate.

Different parts of the body absorb the x-rays in varying degrees. Dense bone absorbs much of

the radiation while soft tissue, such as muscle, fat and organs, allow more of the x-rays to pass

through them. As a result, bones appear white on the x-ray, soft tissue shows up in shades of

gray and air appears black.

Until recently, x-ray images were maintained as hard film copy (much like a photographic

negative). Today, most images are digital files that are stored electronically. These storedimages are easily accessible and are frequently compared to current x-ray images for diagnosis

and disease management.

The technologist, an individual specially trained to perform radiology examinations, positions

the patient on the x-ray table and places the x-ray film holder or digital recording plate under

the table in the area of the body being imaged. When necessary, sandbags, pillows or other

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CSSD EQUIPMENT

Sterilizers:

We manufacture a wide array of medical sterilizer and hospital sterilizer that are

available with different features to facilitate the process of sterilizing which is one of

the most important aspects of medical practice. These are made of superior quality

material like stainless steel that makes them hygienic by preventing them from being

prey to rust. The different variety includes, Triple Chamber Autoclave, Double

Drum Autoclave SS, Single Drum Autoclave Aluminum etc.

Horizontal Rectangular High Pressure Steam Sterilizer

In our medical sterilizer horizontal autoclave is available in

triple-walled (jacketed). Triple-walled execution is preferably

used in hospitals for sterilization of all goods, suitable for the

dressing drums size up to 12x15 Inches especially of infectious

garbage & laboratory waste. The garbage sacks are sterilized inbuckets, which are placed one above the other. Our medical

sterilizer hasinner and outer wall made of heavy gauge of stainless steel and

Construction of the unit totally made of 304 stainless steel heavy gauge sheet middle

jacket made of brass or stainless steel and gun metal

Technical Data:

Steam Working Pressure 1.26 kgf/cm2 (2.2 kgf/cm2 in case High speed

sterilizer

Steam Working Temperature 121oC

Operating Voltage 240, single phase, AC supplies, 50 Hz.



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MINI PROJECT BIOMEDICAL ENGINEERING BVRITabove the other. In hospital sterilizer inner and outer wall made of heavy gauge of

stainless steel and middle jacket made of brass and gun metal

Technical Data:

Steam Working Pressure 1.26 kgf/cm2 (2.2 kgf/cm2 in case High speed

sterilizer

Steam Working Temperature 121oC

Operating Voltage 240, single phase, AC supply, 50 Hz.

Sterilization Period 45 to 50 minutes.

Radiant locking system, cold water drainage system Steam

Exhaust:

5 to 7 provided with timer from 1 to 60 Min with double safety valve, steam

releasing valve, pressure gauge for the pressure inside the chamber, and one pressure

gauge to show the pressure of outer chamber both the chamber made of stainless

steel lid of the unit made of heavy duty gun metal piece for extra safety, gasket,

water level indicator to see the water inside, heavy duty power plug with socket

provided with the unit

Accessories:

One spare element, and two gaskets, our common size 400x1200 mm

Vertical Sterilizer



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MINI PROJECT BIOMEDICAL ENGINEERING BVRITSterilization accessories:

Auto claves

Ultra sonic cleaners

Autoclave racks

Instrument Trays

Autoclave Chemicals

Autoclave supplies and testing

The main objectives of the Central Sterile Supply Department are: To provide sterilized material from a central department where sterilizing

practice is conducted under conditions, which are controlled, thereby

contributing to a reduction in the incidence of hospital infection.

To take some of the work of the Nursing staff so that they can devote more

time to their patients.

To maintain record of effectiveness of cleaning disinfections and sterilization

process.

To monitor and enforce controls necessary to prevent cross infection

according to infection control policy.

To maintain an inventory of supplies and equipment.

To stay updated regarding developments in the field in the interest of

efficiency, economy, accuracy and provision of better patient care.

To provide a safe environment for the patients and staff.

Technical Data:



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Steam

Working

Pressure

1.26 kgf/cm2 (2.2 kgf/cm2 in case High

speed sterilizer

Steam

Working

Temp

121oC (134o in case of High speed

sterilizer)

Hyd. Tested at Jacket-Twice the working pressure.

Chamber-One & half time the working

pressure.

Operating

Voltage

400/440, 3 phase, AC supply, 50c/s.

Sterilization

Period

20 to 25 minutes(in case of High speed

sterilizer 5 to 7 minutes).

Steam Exhaust 5 to 7 minutes (in case of High speed

sterilizer 1 minute)


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INDICATORS

In the process of sterilization of medical instruments a indicator is used by the

operator to find out weather the material in the sterilizer is completely sterile or not. A paper like

substance which is applied with some chemical is used as an indicator. Initially the tape will be

yellow in color, after sterilization it turns black.

It is called AUTO CLAVE. This indicator is attached to the

material to be sterilized and verified after sterilization process.


Documents

By Dinesh Gannerlla