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Mobile Diagnostics Clinic

For School Health Care Programme And Rural Area Health Care Programme

Shiva Medicare

Dipl.-Ing. Monoj Kumar Chowdhury Strassmannstr. 44 10249 Berlin Germany Tel: +49 (030) 921 28 323 +49 177 28 25 069 Fax: +49 (030) 921 28 328 Email: [email protected] www.shivamed.com

Shiva Medicare GmbH established 2006 in Berlin, Germany and England and also going to set up in Indian Subcontinent, offers innovative hi-tech products and solution in Magnetic Resonance Imaging. Since 2006 Shiva Medicare is the distributor of "Paramed", medical system of Genoa, Italy, for the East Part of Germany, Great Britain and Indian Subcontinent and also responsible for the service and application in Germany, Great Britain, Austria, Switzerland, Nederland, Poland and Indian Subcontinent. Paramed medical System is a producer of world wide famous Extremity MRI Producer. Shiva Medicare is also the Exclusive producer and distributor of "MRJ" mobile MRI Unit all over the world. Our Company is specialized in developing and construction of mobile MRI and mobile Diagnostics Clinic. We Produce our Unit in Berlin Germany. Magnetic resonance imaging is a method of looking inside the body to using magnetism and radio waves to produce clearer pictures of the head, spine, and other parts of the body. The MRI produces soft-tissue images and is used to distinguish normal, healthy soft tissue from diseased tissue. Our mobile Diagnostics Clinic is a modern high-tech medical unit with an extremity Open MRI system, ultrasound, ECG, blood test lab etc. on board. An open scanner is used to avoid the problem of claustrophobia that some patients experience with a traditional enclosed MRI scanner. The mobile diagnostics Clinic gives you a place independent access to state-of-the-art medical diagnostic technology. The mobility of mobile Diagnostics Clinic saves your costs and time is very convenient and opens up new possibilities. The mobile service is an innovative new way of providing the latest medical diagnostic technology to residents of rural area without them having to travel to urban centres. Apart from the considerable price advantage (one third of the price of competitors) stands out in terms of mobility and the small size of the truck. The Unit has its own Power supply and also crucially electricity can be supplied from a standard 16 Amp socket. The latest computer technology is employed, to enable rapid dispatch of scan and examine results to the referring professional. We using also the modern tele-radiology in our mobile Diagnostics Clinic so there is also the possibility to carry out a Video conference with some other medical specialist from the Mobile Unit. Telehealth and telemedicine services can provide patients in rural areas access to medical specialties in areas like Orthopaedic and radiology -- in some instances without leaving their homes or communities. It will allow patients to heal and recover in a more familiar environment. The system also could be transitioned for emergency use in the event of a natural or other disaster.

The scanner is a low field (0.22 Tesla) scanner with superior coils and software, which gives accurate and high quality pictures. This magnet is mounted on a 18t truck and therefore mobile. Patients are scanned and examine on the truck. The open magnet design is an additional attraction for a considerable patient segment (claustrophobic patients). Quite a few patients do not like to be scanned in a tube, which is very claustrophobic and loud. Our MRI magnet is open, u-shaped and very quiet and therefore feels less threatening to the customer being scanned. This is also an advantage for children, where the parents can sit next to them and hold their hand / reassure them, which is not possible with a traditional closed magnet / larger scanners. The small size of the mobile Unit, with attendant efficiency and operating cost advantages to provide diagnostic services closer to the patients home, in that it allows economic mobile unit operation at GP health centres, community hospitals etc. This is not possible with the traditional mobile Unit which requires mounting on a 40 ton articulated lorry. There are no other mobile small units like Shiva Medicare about. As far as is known, all the other mobile units are 40 ton trucks, articulated with 18 t and 1.5 Tesla scanners.

· Mobile Diagnostics Clinic and its equipment:

· · · · · · · · · · · · · · · Truck Solar System on Truck (Optional) MRI Unit MrJ Extended Ultrsonography for all kind of examination Eyetest System Audiometer Blood test Unit ECG Emergency Drugstore Small Emergency surgical Set Surgical Couch Small sterile System Pulse Oximeter Blood Pressure ­ NIBP Precision Health Scal ­ Weight and BMI

For further necessary equipments please contact with us

Mobile Diagnostics Clinic and its equipment

Magnetic Resonance Imaging Ultrasonographic Color Doppler

ECG

Blood Analyzer

Urin Analyger

Audiometer Eyetest Unit

Mobile Diagnostics Clinic and its equipment

Surgical Couch

Emergency small surgical Set Pulse Oximeter

Health Scale Weight and BMI

Small Sterile

Infrared - Ear Thermometer Blood Pressure - NIBP

Emergency Drugstore

"The Fotos are given for illustration"

About MRI (magnetic resonance imaging):

Our Extrymity MRI system is for all Extremities inclusive Shoulder, Hip, Cervical and Lumbar Spine

MRI (magnetic resonance imaging) is a fairly new technique that has been used since the beginning of the 1980s. The MRI scan uses magnetic and radio waves, meaning that there is no exposure to Xrays or any other damaging forms of radiation. In conjunction with radio wave pulses of energy, the MRI scanner can pick out a very small point inside the patient's body and ask it, essentially, "What type of tissue are you?" The point might be a cube that is half a millimeter on each side. The MRI system goes through the patient's body point by point, building up a 2-D or 3-D map of tissue types. It then integrates all of this information together to create 2-D images or 3-D models. MRI provides an unparalleled view inside the human body. The level of detail we can see is extraordinary compared with any other imaging modality. MRI is the method of choice for the diagnosis of many types of injuries and conditions because of the incredible ability to tailor the exam to the particular medical question being asked. By changing exam parameters, the MRI system can cause tissues in the body to take on different appearances. This is very helpful to the radiologist (who reads the MRI) in determining if something seen is normal or not.

Every time you walk your child to school, settle into a chair for a good-night story, or wrap your arms around your child in a hug, you're using your bones, muscles, and joints. Without these important body parts, you and your child wouldn't be able to stand, walk, run, or even sit. From our head to our toes, our bones provide support for our bodies and help form our shape. The skull protects the brain and forms the shape of our face. The spinal cord, a pathway for messages between the brain and the body, is protected by the backbone, or spinal column. Although they're very light, bones are strong enough to support our entire weight.

Joints occur where two bones meet. They make the skeleton flexible - without them, movement would be impossible. Muscles are also necessary for movement: They're the masses of tough, elastic tissue that pull our bones when we move. Together, our bones, muscles, and joints - along with tendons, ligaments, and cartilage - form our musculoskeletal systems and enable us to do everyday physical activities MRI is the investigation of choice for patients with unexplained pain, swelling or abnormal function, such as restricted movement or intermittent locking. An MR scan can demonstrate conditions such as the fllowing:

Osteoarthritis ("Wear and tear" or "degeneration"). This is one of the commonest joint conditions and while typically a disease of the elderly, can occur in young and middle-aged patients for a variety of reasons. These include previous joint trauma, genetic factors, high body mass index (overweight patients)or damage to the joint cartilages. The value of MR is to answer the following questions:

Are osteoarthritic changes present? If so, how advanced is the degeneration Are there any treatable lesions, such as a torn meniscus (cartilage) or loose body, which can be corrected and slow the progression of the osteoarthritis Is the degeneration at a stage where joint replacement should be considered?

The main feature of joint degeneration is the wearing away and thinning of the articular cartilage, which is the slippery substance which lines the joint surfaces and normally allows free and painless movement of the joint. Once the cartilage has worn away the bone will become damaged and the joint becomes more painful and may be restricted in movement. MRI will demonstrate the amount of articular cartilage loss, the presence or absence of associated bone damage and the state of the menisci. This information will allow planning of optimum therapy. MRI will give far more information than the plain radiograph, which only shows the bone and is generally most useful in end stage disease. The plain films give no information about articular cartilage, and damage to the menisci and ligaments of the knee. However the MR scan will show any damage to the internal structures of the knee, and also provide information about the tendons, muscles and other soft tissues , and will identify any inflammation within or adjacent to the knee joint.

Ultrasonography:

A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echo patterns are shown on the screen of an ultrasound machine, forming a picture of body tissues called a sonogram. Also called ultrasound

Ultrasound imaging has become part of our lives in the last decade. We are now all familiar with the blurry black and white sonograms (ultrasound pictures) that show the unborn baby inside the mother?s uterus. Although it may take a little imagination on our part to understand that a round circle is the baby?s head, that does not prevent a proud mother-to-be from showing off her first baby picture.

ultrasonography is an ultrasound-based diagnostic imaging technique used to visualize muscles and internal organs, their size, structures and possible pathologies or lesions. Obstetric sonography is commonly used during pregnancy and is widely recognized by the public. There are a plethora of diagnostic and therapeutic applications practiced in medicine.

Sonography (ultrasonography) is widely used in medicine. It is possible to perform diagnosis or therapeutic procedures with the guidance of sonography (for instance biopsies or drainage of fluid collections). Sonographers are medical professionals who

perform scans for diagnostic purposes. Sonographers typically use a hand-held probe (called a transducer) that is placed directly on and moved over the patient. A water-based gel is used to couple the ultrasound between the transducer and patient.

In today's imaging marketplace the customer requires a balance between high quality diagnostic performance and good affordability.

This System offers complete imaging modes: 2D, M, PW, HPRF, CW, Color, Power and DirPower. CW (continuous wave Doppler) and Free XrosTM Imaging (anatomical M mode ) for more accurate cardiac diagnosis. Smart3D leads to vivid ultrasound healthcare, iScape View(panoramic imaging) and trapezoidal imaging expands to a wider field of vision.

Auto Hematology Analyzer

Just about everyone knows that we can't live without blood. Without blood, our organs couldn't get the oxygen and nutrients they need to survive, we couldn't keep warm or cool off, we couldn't fight infections, and we couldn't get rid of our own waste products. Without enough blood, we'd weaken and die. So how exactly does blood do these things? How is it made, and what's in it? How does blood clot? These questions and more are explained in this article about the mysterious, life-sustaining fluid called blood.

Features:

WBC; 19 parameters + 3 histogram 2 counting modes: whole blood and prediluted Counting speed: 60 samples per hour Automatic diluting, lyzing, mixing, rinsing and un-clogging Automatically cleaning sampling probe Parameters (including histogram) of 35000 samples can be stored Parameters: WBC, Lymph#, Mid#, Gran#, Lymph%, Mid%, Gran%, RBC, HGB, HCT, MCV MCH, MCHC, RDW-CV, RDW-SD, PLT, MPV, PDW, PCT and Histogram for WBC, RBC, PLT

Urine Analyzer

Parameter: Urobilinogen, Bilirubin, Ketone, Blood, Protein, Nitrite, Leukocytes, Glucose, Specific Gravity, Ascorbic Acid, PH

Wavelength of monochromatic light: 557nm, 620 nm, 656 nm

ECG(electrocardiogram):

What is an ECG?: ECG (electrocardiogram) is a test that measures the electrical activity of the heart. The heart is a muscular organ that beats in rhythm to pump the blood through the body. The signals that make the heart's muscle fibres contract come from the sinoatrial node, which is the natural pacemaker of the heart.

In an ECG test, the electrical impulses made while the heart is beating are recorded and usually shown on a piece of paper. This is known as an electrocardiogram, and records any problems with the heart's rhythm, and the conduction of the heart beat through the heart which may be affected by underlying heart disease.

What is the resting ECG used for? The information obtained from an electrocardiogram can be used to discover different types of heart disease. It may be useful for seeing how well the patient is responding to treatment.

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It is a good idea to have an ECG in the case of symptoms such as dyspnoea (difficulty in breathing), chest pain (angina), fainting, palpitations or when someone can feel that their own heart beat is abnormal.

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The test can show evidence of disease in the coronary arteries. Unfortunately, in many people who have significant narrowing of the arteries supplying the heart muscle, the ECG recording made at rest is often normal. Therefore, if a significant narrowing is suspected, an ECG recording is often made when the patient is exercising (an exercise stress test) as this is more likely to reveal the problem.

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An ECG can be used to assess if the patient has had a heart attack or evidence of a previous heart attack.

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An ECG can be used to monitor the effect of medicines used for coronary artery disease.

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An ECG reveals rhythm problems such as the cause of a slow or fast heart beat. To demonstrate thickening of a heart muscle (left ventricular hypertrophy), for example due to long-standing high blood pressure.

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To see if there are too few minerals in the blood.

An ECG may appear normal even in the presence of significant heart disease. Thus, for a full assessment of the heart, other tests may be needed.

Precision Health Scale - Weight and BMI:

Health Scale ­Weight and BMI offers a new value in Professional Digital Scales. Featuring the design profile of our classic beam scale, this new all-digital medical scale advances the Health o meter tradition of quality, reliability, and ease-of-use. This electronic physician scale is full of features. Health scales are affordable medical scales full of features appealing to doctor's offices, hospitals, clinics, fitness centers, acute-care and, long-term care facilities. This digital physician scale offers a user-friendly digital interface which includes BMI (Body Mass Index), Hold/Release, Zero, KG/LB, Clear, and Enter functions. Health-fitness scale operates on 6 AA batteries or an AC adapter. According to the NHLBI guidelines, assessment of overweight involves using three key measures:

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body mass index (BMI) waist circumference, and risk factors for diseases and conditions associated with obesity.

The BMI is a measure of your weight relative to your height and waist circumference measures abdominal fat. Combining these with information about your additional risk factors yields your risk for developing obesity-associated diseases. What is Your Risk? BMI is a reliable indicator of total body fat, which is related to the risk of disease and death. The score is valid for both men and women but it does have some limits. The limits are:

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It may overestimate body fat in athletes and others who have a muscular build. It may underestimate body fat in older persons and others who have lost muscle mass.

Body mass index (BMI) is a measure of body fat based on height and weight that applies to both adult men and women.

Body Mass Index (BMI) can be used to indicate if you are overweight, obese, underweight or normal. It will, however, overestimate fatness in people who are muscular or atheletic. Because of these problems, this body mass index calculator shows extra statistics to help you be informed and judge your own body compared to others of the same height and age. Also offered are average weight and height charts and Body Mass Index charts, which show data you just can't find anywhere else.

Pulse Oximeter

A pulse oximeter is a medical device that indirectly measures the oxygen saturation of a patient's blood (as opposed to measuring oxygen saturation directly through a blood sample) and changes in blood volume in the skin, producing a photoplethysmograph. It is often attached to a medical monitor so staff can see a patient's oxygenation at all times. Most monitors also display the heart rate.

A blood-oxygen monitor displays the percentage of arterial hemoglobin in the oxyhemoglobin configuration. Acceptable normal ranges are from 95 to 100 percent. For a patient breathing room air, at not far above sea level, an estimate of arterial pO2 can be made from the blood-oxygen monitor SpO2 reading. A pulse oximeter is a particularly convenient non-invasive measurement instrument. Typically it has a pair of small light-emitting diodes (LEDs) facing a photodiode through a translucent part of the patient's body, usually a fingertip or an earlobe. One LED is red, with wavelength of 660 nm, and the other is infrared, 905, 910, or 940 nm. Absorption at these wavelengths differs significantly between oxyhemoglobin and its deoxygenated form, therefore from the ratio of the absorption of the red and infrared light the oxy/deoxyhemoglobin ratio can be calculated. The absorbance of oxyhemoglobin and

deoxyhemoglobin is the same (isosbestic point) for the wavelengths of 590 and 805 nm; earlier oximeters used these wavelengths for correction for hemoglobin concentration.

The monitored signal bounces in time with the heart beat because the arterial blood vessels expand and contract with each heartbeat. By examining only the varying part of the absorption spectrum (essentially, subtracting minimum absorption from peak absorption), a monitor can ignore other tissues or nail polish[2] and discern only the absorption caused by arterial blood. Thus, detecting a pulse is essential to the operation of a pulse oximeter and it will not function if there is none.

The latest generation pulse oximeters use digital signal processing to make accurate measurements in clinical conditions that were otherwise impossible. These include situations of patient motion, low perfusion, bright ambient light, and electrical interference. Because of their insensitivity to non-pulsate signals, it is also possible to build reflectance probes that place the photodiode beside the LEDs and can be placed on any flat tissue. These can be used on non-translucent body parts, to measure pulses in specific body parts (useful in plastic surgery), or when more convenient sites are unavailable (severe burn victims). They are commonly applied to the forehead of patients with poor peripheral perfusion.

Boold Pressure ­ NIBP:

The Non-invasive Blood Pressure (NIBP) Module is used to monitor blood pressure of patients non-invasively in Intensive Care Units (ICUs). Continuous monitoring of arterial blood pressure and peripheral vascular resistance during surgery as well as in ICU is very essential. The NIBP module uses oscillometric method for the measurement of blood pressure. It comprises of a tourniquet, a pressure transducer, an inflation pump and deflation solenoid valve connected to electronic circuitry. The rate of change of pressure

(dP/dt) during deflation is used to derive mean, systolic and diastolic blood pressures, in contrast to change in pressure (P) waveform used in commercially available modules. The advantage of dP/dt waveform over P is the accurate determination of mean blood pressure. Systolic, diastolic and mean blood pressures are provided repetitively with an average period of 10 minutes (programmable). This module can be coupled with non-invasive cardiac output monitor for monitoring peripheral vascular resistance of the patient and can also be used as a stand alone instrument with a microcontroller and a display unit.

Blood pressure (strictly speaking: vascular pressure) refers to the force exerted by circulating blood on the walls of blood vessels, and constitutes one of the principal vital signs. The pressure of the circulating blood decreases as blood moves through arteries, arterioles, capillaries, and veins; the term blood pressure generally refers to arterial pressure, i.e., the pressure in the larger arteries, arteries being the blood vessels which take blood away from the heart. Arterial pressure is most commonly measured via a sphygmomanometer, which uses the height of a column of mercury to reflect the circulating pressure (see Non-invasive measurement). Although many modern vascular pressure devices no longer use mercury, vascular pressure values are still universally reported in millimetres of mercury (mmHg). The systolic arterial pressure is defined as the peak pressure in the arteries, which occurs near the beginning of the cardiac cycle; the diastolic arterial pressure is the lowest pressure (at the resting phase of the cardiac cycle). The average pressure throughout the cardiac cycle is reported as mean arterial pressure; the pulse pressure reflects the difference between the maximum and minimum pressures measured.

What is blood pressure? Blood pressure is the pressure of the blood against the walls of the arteries. Blood pressure results from two forces. One is created by the heart as it pumps blood into the arteries and through the circulatory system. The other is the force of the arteries as they resist the blood flow.

What do blood pressure numbers indicate?

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The higher (systolic) number represents the pressure while the heart contracts to pump blood to the body.

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The lower (diastolic) number represents the pressure when the heart relaxes between beats.

The systolic pressure is always stated first. For example: 118/76 (118 over 76); systolic = 118, diastolic = 76. Blood pressure below 120 over 80 mmHg (millimeters of mercury) is considered optimal for adults. A systolic pressure of 120 to 139 mmHg or a diastolic pressure of 80 to 89 mmHg is considered "prehypertension" and needs to be watched carefully. A blood pressure reading of 140 over 90 or higher is considered elevated (high).

How can I tell if I have high blood pressure? High blood pressure usually has no symptoms. In fact, many people have high blood pressure for years without knowing it. That's why it's called the "silent killer." Hypertension is the medical term for high blood pressure. It doesn't refer to being tense, nervous or hyperactive. You can be a calm, relaxed person and still have high blood pressure. A single elevated blood pressure reading doesn't mean you have high blood pressure, but it's a sign that further observation is required. Ask your doctor how often to check it or have it checked. Certain diseases, such as kidney disease, can cause high blood pressure. In 90 to 95 percent of cases, the cause of high blood pressure is unknown. The only way to find out if you have high blood pressure is to have your blood pressure checked. Your doctor or other qualified health professional should check your blood pressure at least once every two years, or more often if necessary.

Optimal blood pressure with respect to cardiovascular risk is less than 120/80 mm Hg. However, unusually low readings should be evaluated to rule out medical causes.

Infrared Ear Thermometer:

Signatrol SL-IRT - Infra Red Thermometer What is the advantage of an infra red thermometer over a conventional probe thermometer? Fast and accurate surface temperatures can be take almost instantly without the need to touch the substance or item being measured, therefore avoiding cross contamination. The SL-IRT is compact, lightweight and easy to use. Supplied with a laser sight, just aim, pull the trigger and read the temperature! The SL-IRT measures temperature over the range -60°C to +500° with an accuracy of C ±1° over the range 0° to +65° and ±2° outside t his. C C C C The SL-IRT is powered by 2 AAA size batteries and a single pair of batteries will give over 140 hours continuous use. The SL-IRT has a fixed emissivity of 0.97

Small Sterile:

An efficient aid for the cleaning and the thermal disinfection of all Medical and Laboratory instruments. A washer of a modern concept, designed and constructed in compliance with the guidelines indicated in the new European Norm concerning safety and hygiene. The washer can be placed on any work surface and is simple to install, the built-in detergent compartment and dispenser are standard features.

Ear test:

In the first few years of life, hearing is a critical part of a child's social, emotional, and cognitive development. Even a mild or partial hearing loss can affect a child's ability to speak and understand language. Hearing loss is a very common birth defect. Approximately 1 to 3 out of every 1,000 babies is born with some degree of hearing loss. There are a number of factors that can lead to hearing loss, and about half the time, no cause is found.

Traditional or Standard Audiometry This testing is used with older children and adults. The method requires the patient to press a response button or raise a hand when the test tone is heard.

Other Tests Tympanometry or Acoustic Immittance Testing is often an integral part of the test battery. This test is used to assess the status of the middle ear and related structures. Tympanometry measures the movement of the ear drum (tympanic membrane). This information is used in the diagnosis of middle ear disease or other problems that might alter ear drum movement. Acoustic Reflexes are measured in order to determine whether the middle ear muscles are properly reacting to loud sounds. This test can also be used in establishing young children's hearing status and or to identify other hearing problems. Auditory Brainstem Response Audiometry (ABR), or Brainstem Evoked Response (BSER), is an objective procedure measuring the function of the brainstem in response to sound. The results can provide general information regarding hearing sensitivity. This test is also used for neuro-diagnostic purposes to determine if the brainstem is transmitting sound properly. A series of clicks or tones are presented to the patient while she/he rests

or sleeps. Electrodes are placed on the patient's head to detect the response of the brainstem to the sounds. The electrodes do not cause any pain or discomfort. Otoacoustic Emissions (OAEs) are objective measures used to determine cochlear (inner ear) function. Emissions are usually present if hearing is normal or if a mild hearing loss is present. Emissions may not be detected if there is a conductive hearing loss, middle ear involvement such as an ear infection, or more than a mild sensorineural hearing loss. This is a quick procedure and does not create any discomfort.

Eye test:

Early detection, through regular and complete eye exams, is the key to protecting your vision from damage caused by glaucoma. It is important to have your eyes examined regularly

We depend on sight more than any other of our senses to maneuver through the space around us. In a single glance, lasting a fraction of a second, our eyes work with our brains to tell us the size, shape, color, and texture of an object. They let us know how close it is, whether it's standing still or coming toward us, and how quickly it's moving. Every day, our eyes give us messages that help us understand the world around us.

Although the eyes are small compared to most of the body's other organs, their structure is incredibly complex. The eyes work together to perceive depth, enabling us to judge distance and the size of objects to help us move around them. Not only do the two eyes work together, they also work with the brain, muscles, and nerves to produce complicated visual images and messages. And our eyes constantly adapt to the changing environment - for example, they are able to adjust so that we can easily move around in a nearly dark room or bright sunlight.

To understand more about how the eyes work, it's important to know about the structures that make up the eye and about conditions and diseases that can interfere with vision.

Emergency Drugstore:

Small Emergency Surgical Set:

Surgical Couch:

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