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Teledentistry in practice: literature review

Khan SA, Omar H

Telemed J E Health, 2013 Jul;19(7):565-7.
PMID: 23672799 DOI: 10.1089/tmj.2012.0200

Teledentistry can be defined as the remote provision of dental care, advice, or treatment through the medium of information technology, rather than through direct personal contact with any patient(s) involved. Within dental practice, teledentistry is used extensively in disciplines like preventive dentistry, orthodontics, endodontics, oral surgery, periodontal conditions, detection of early dental caries, patient education, oral medicine, and diagnosis. Some of the key modes and methods used in teledentistry are electronic health records, electronic referral systems, digitizing images, teleconsultations, and telediagnosis. All the applications used in teledentistry aim to bring about efficiency, provide access to underserved population, improve quality of care, and reduce oral disease burden.
Fulltext Insights from the preliminary autocorrelation analysis of low frequency neuronal oscillations during Quran listening

Reza, F., Begum, T., Ahmed, A.L., Omar, H., Muzaimi, M., Abdullah, J.M.

ASM Science Journal, 2012;6(1):39-45.
MyJurnal

The human brain generates different oscillations at different frequencies during various consciousness levels. When these brain waves synchronize with exogenous rhythmic stimulation, the brain experiences strong, yet relaxing emotion that could be involved in the formation of memory. We investigated the character of rhythmic oscillatory dynamics by electroencephalography (EEG) of subjects listening to a short verse of the Holy Quran compared to resting and Arabic news listening. The mean power amplitudes of each frequency band for wavelet-based time-frequency analysis were obtained from 5000 ms of segmented EEG recordings during rest, news and Quran listening conditions. The time series analysis of power from each of three conditions in each frequency band from the grand averaged data was then subjected to autocorrelation study. The results showed significant cyclic overall trends of increasing and decreasing patterns of power in the low frequency brain wave oscillation of different head regions especially global, frontal and temporal sites. These results provided a basis for prediction of the periodicity of the power of the oscillatory brain dynamics of delta and robustly in theta regions which occurred during Quran listening. Despite several limitations, our data offered a plausible scientific basis to the emotional induction during Quran listening that mimics recognized as data from music listening studies. This offered a promising perspective for future studies in translational neurophysiological, cognitive and biofeedback on Quran listening to modify brain behaviour in health and disease.
Fulltext Time-series maps of aboveground biomass in dipterocarps forests of Malaysia from PALSAR and PALSAR-2 polarimetric data

Omar H, Misman MA

Carbon Balance Manag, 2018 Oct 19;13(1):19.
PMID: 30341540 DOI: 10.1186/s13021-018-0108-2

BACKGROUND: Malaysia typically suffers from frequent cloud cover, hindering spatially consistent reporting of deforestation and forest degradation, which limits the accurate reporting of carbon loss and CO2 emissions for reducing emission from deforestation and forest degradation (REDD+) intervention. This study proposed an approach for accurate and consistent measurements of biomass carbon and CO2 emissions using a single L-band synthetic aperture radar (SAR) sensor system. A time-series analysis of aboveground biomass (AGB) using the PALSAR and PALSAR-2 systems addressed a number of critical questions that have not been previously answered. A series of PALSAR and PALSAR-2 mosaics over the years 2007, 2008, 2009, 2010, 2015 and 2016 were used to (i) map the forest cover, (ii) quantify the rate of forest loss, (iii) establish prediction equations for AGB, (iv) quantify the changes of carbon stocks and (v) estimate CO2 emissions (and removal) in the dipterocarps forests of Peninsular Malaysia.
RESULTS: This study found that the annual rate of deforestation within inland forests in Peninsular Malaysia was 0.38% year-1 and subsequently caused a carbon loss of approximately 9 million Mg C year-1, which is equal to emissions of 33 million Mg CO2 year-1, within the ten-year observation period. Spatially explicit maps of AGB over the dipterocarps forests in the entire Peninsular Malaysia were produced. The RMSE associated with the AGB estimation was approximately 117 Mg ha-1, which is equal to an error of 29.3% and thus an accuracy of approximately 70.7%.
CONCLUSION: The PALSAR and PALSAR-2 systems offer a great opportunity for providing consistent data acquisition, cloud-free images and wall-to-wall coverage for monitoring since at least the past decade. We recommend the proposed method and findings of this study be considered for MRV in REDD+ implementation in Malaysia.
Development and implementation of an e-tutorial to provide tobacco cessation training for dental students

Omar H, Bilal S

J Dent Educ, 2020 Dec 13.
PMID: 33314054 DOI: 10.1002/jdd.12520
Fulltext Evaluation of gait performance of a hemipelvectomy amputation walking with a canadian prosthesis

Karimi MT, Kamali M, Omar H, Mostmand J

Case Rep Orthop, 2014;2014:962980.
PMID: 24822145 DOI: 10.1155/2014/962980

Background. Hemipelvectomy amputation is a surgical procedure in which lower limb and a portion of pelvic are removed. There are a few studies in the literature regarding the performance of subjects with hip disarticulation during walking. However, there is no study on gait analysis of hemipelvectomy subject. Therefore, the aim of this paper was to evaluate the gait and stability of subject with hemipelvectomy amputation. Case Description and Methods. A subject with hemipelvectomy amputation at right side was involved in this study. He used a Canadian prosthesis with single axis ankle joint, 3R21 knee joint, and 7E7 hip joint for more than 10 years. The kinetic and kinematic parameters were collected by a motion analysis system and a Kistler force platform. Findings and Outcomes. There was a significant difference between knee, hip, and ankle range of motions and their moments in the sound and prosthesis sides. In the other side, the stability of the subject in the anteroposterior direction seems to be better than that in the mediolateral direction. Conclusions. There was a significant asymmetry between the kinetic and kinematic performance of the sound and prosthesis sides, which may be due to lack of muscular power and alignment of prosthesis components.
Structured student-generated videos for first-year students at a dental school in Malaysia

Omar H, Khan SA, Toh CG

J Dent Educ, 2013 May;77(5):640-7.
PMID: 23658411

Student-generated videos provide an authentic learning experience for students, enhance motivation and engagement, improve communication skills, and improve collaborative learning skills. This article describes the development and implementation of a student-generated video activity as part of a knowledge, observation, simulation, and experience (KOSE) program at the School of Dentistry, International Medical University, Kuala Lumpur, Malaysia. It also reports the students' perceptions of an activity that introduced first-year dental students (n=44) to clinical scenarios involving patients and dental team aiming to improve professional behavior and communication skills. The learning activity was divided into three phases: preparatory phase, video production phase, and video-watching. Students were organized into five groups and were instructed to generate videos addressing given clinical scenarios. Following the activity, students' perceptions were assessed with a questionnaire. The results showed that 86 percent and 88 percent, respectively, of the students agreed that preparation of the activity enhanced their understanding of the role of dentists in provision of health care and the role of enhanced teamwork. In addition, 86 percent and 75 percent, respectively, agreed that the activity improved their communication and project management skills. Overall, the dental students perceived that the student-generated video activity was a positive experience and enabled them to play the major role in driving their learning process.
Occurrence of shell deformities in green-lipped mussel Perna viridis (Linnaeus) collected from Malaysian coastal waters

Yap CK, Ismail A, Tan SG, Omar H

Bull Environ Contam Toxicol, 2002 Dec;69(6):877-84.
PMID: 12428166
Anopheles balabacensis balabacensis identified as a vector of monkey malaria in malaya

Cheong WH, Omar HB, Warren M, Mahadevan S

Med J Malaya, 1965 Sep;20(1):76.
PMID: 4221433
Fulltext Role of ethical beliefs and attitudes of dental students in providing care for HIV/AIDS patients

Khan SA, Liew ML, Omar H

Saudi Dent J, 2017 Jan;29(1):7-14.
PMID: 28270704 DOI: 10.1016/j.sdentj.2016.08.005

INTRODUCTION: Dental care has remained as an unmet need for people living with HIV/AIDS (PLWHAs). Dental students are considered as future healthcare workforce and having beliefs which are discriminating may have negative attitudes towards providing care to these individuals (Azodo et al., 2010). The study aimed to assess the ethical beliefs and attitudes of dental students towards PLWHAs for providing care.
METHODS: It is a descriptive correlational and cross sectional study. Nine public and private dental schools in Malaysia participated in the study. Data was collected using a validated self-administered questionnaire.
RESULTS: A total of 481 dental students participated in this study, yielding response rate of 78%. Majority of the participants (74%) believed that patients' HIV status should be disclosed to patients' sexual partner without permission. Approximately 60% of the participants reported that rooms/beds of HIV patients should be clearly marked. Regarding patient disease status 28% of the students reported that it is appropriate to test a patient for HIV/AIDS without patient's permission. Only Fifty five percent of the students expressed the willingness to treat HIV patients and 49% reported to held fear of getting infected while treating patients with HIV/AIDS. Sixty four percent of the participants reported to be more comfortable giving care to non-HIV patients than HIV-positive patients.
CONCLUSION: Dental students' ethical beliefs about HIV/AIDS were not consistent with the ethical principles as stated in the code of ethics and they held negative attitudes towards PLWHAs. Ethical beliefs were found to be a determinant that may influence future attitudes of these students towards individuals with HIV/AIDS when providing care.
Removal of free fatty acid (FFA) in crude palm oil (CPO) using potassium oxide/dolomite as an adsorbent: Optimization by Taguchi method

Nor Shafizah I, Irmawati R, Omar H, Yahaya M, Alia Aina A

Food Chem, 2022 Mar 30;373(Pt B):131668.
PMID: 34848088 DOI: 10.1016/j.foodchem.2021.131668

In this study, potassium oxide supported on dolomite adsorbent was used as an adsorbent for free fatty acids (FFAs) treatment in crude palm oil (CPO). The characteristics of the adsorbent were determined by TGA, XRD, SEM, BET and TPD-CO2. Taguchi method was utilized for experimental design and optimum condition determination. There were four parameters and three levels involved in this study: time (30, 60, 90 min), stirring rate (300, 500, 700 rpm), adsorbent dosage (1, 3, 5 wt%) and K2O concentration (5, 10, 15 wt%). The adsorbent had a larger pore size, higher basic strength, and more basic sites in greater efficiency (63%) in FFAs removal from CPO. The optimum conditions were at 30 min time, 700 rpm stirring rate, 5 wt% adsorbent dosage and 15 wt% K2O concentration. Taguchi method simplified determination of experimental parameters and minimized the operating costs.
Toxicities and tolerances of Cd, Cu, Pb and Zn in a primary producer (Isochrysis galbana) and in a primary consumer (Perna viridis)

Yap CK, Ismail A, Omar H, Tan SG

Environ Int, 2004 Feb;29(8):1097-104.
PMID: 14680893

Studies on toxicities and tolerances of cadmium (Cd), copper (Cu), lead (Pb) and zinc (Zn) in the brown alga Isochrysis galbana and in the green-lipped mussel Perna viridis were conducted by short-term bioassays using endpoints growth production and mortality, respectively. The 5-day EC(50) and 24-h LC(50) of these heavy metals were determined in the brown alga and mussel, respectively. The EC(50) values calculated for the alga were 0.74 mg/l for Cd, 0.91 mg/l for Cu, 1.40 mg/l for Pb and 0.60 mg/l for Zn. The LC(50) values for the mussels were 1.53 mg/l for Cd, 0.25 mg/l for Cu, 4.12 mg/l for Pb and 3.20 mg/l for Zn. These LC(50) values were within the concentration ranges as reported by other authors who used P. viridis as the test organism. Based on these EC(50) and LC(50) values, the alga was most sensitive to Zn, followed by Cd, Cu and Pb while the mussel was most sensitive to Cu, followed by Cd, Zn and Pb. Differences in the trophic levels, metal handling strategies, biology and ecology of the primary producer (brown alga) and the primary consumer (mussel) are believed to be the plausible causes for the different toxicities and tolerances of the metals studied.
Allozyme polymorphisms and heavy metal levels in the green-lipped mussel Perna viridis (Linnaeus) collected from contaminated and uncontaminated sites in Malaysia

Yap CK, Tan SG, Ismail A, Omar H

Environ Int, 2004 Mar;30(1):39-46.
PMID: 14664863

It has been widely reported that heavy metal contamination in coastal waters can modify the allozyme profiles of marine organisms. Previous studies have recorded elevated metal concentrations in sediments and mussel tissues off Peninsular Malaysia. In the present study, horizontal starch gel electrophoresis was carried out to estimate the levels of allelic variation of the green-lipped mussel, Perna viridis, collected from one contaminated and three relatively uncontaminated sites off Peninsular Malaysia. Fourteen polymorphic loci were observed. In addition, the concentrations of cadmium, copper, lead, mercury and zinc were determined in the sediments and in the soft tissues of the mussels. Mussels from contaminated site, evidenced by high metal pollution indices (MPI) of the sediment and the mussel tissues, showed the highest percentage of polymorphic loci (78.6%), while those collected from the uncontaminated sites had lower MPI of the sediment and mussel tissue, and exhibited lower percentages of polymorphic loci (35.7-57.1%). The population from the contaminated site showed the highest excess of heterozygosity (0.289) when compared to that of the populations from the three uncontaminated sites (0.108-0.149). Allozyme frequencies at the phosphoglucomutase (PGM; E.C. 2.7.5.1) locus also differed between the contaminated and uncontaminated populations. Previous studies have shown that exposure to heavy metals can select or counter-select for particular alleles at this locus. The present results suggest that allozyme polymorphism in P. viridis is a potential biomonitoring tool for heavy metal contamination but further validation is required.
Concentrations of Cu and Pb in the offshore and intertidal sediments of the west coast of Peninsular Malaysia

Yap CK, Ismail A, Tan SG, Omar H

Environ Int, 2002 Dec;28(6):467-79.
PMID: 12503912

Malaysia is now a developing country and on her way towards being an industrialised one by the year 2020. Most of her industries and urban areas are located on the west coast of Peninsular Malaysia. In addition, the offshore area of the west coast is now one of the busiest shipping lanes in the world. These two phenomena make the intertidal and offshore areas of the west coast of Peninsular Malaysia interesting for scientific studies. Therefore, this study focused on both the offshore and intertidal sediments of the west coast of Peninsular Malaysia. Sampling for sediment samples were done from the northern to the southern ends of the peninsula and these sediment samples were analysed for Cu and Pb. It was found that total Cu concentrations ranged from 0.25 to 13.8 and 0.40 to 315 microg/g dry weight (dw) for offshore and intertidal sediments, respectively. For Pb, it ranged from 3.59 to 25.4 and 0.96 to 69.8 microg/g dw for the offshore and intertidal sediments, respectively. The ranges of Cu and Pb found from the west coast of Peninsular Malaysia were low in comparison to regional data. However, some intertidal areas were identified as receiving anthropogenic Cu and Pb. Geochemical studies revealed that the 'nonresistant' fraction for Pb contributed about 70.0% to 75.0% and 54.0% of the total Pb concentration in the offshore and intertidal sediments, respectively. As for Cu, the 'nonresistant' fraction contributed about 46.2% to 60.4% and 46.3% of the total Cu concentration in the offshore and intertidal sediments, respectively. The 'nonresistant' fraction contained mostly of anthropogenic metals besides natural origins. These 'nonresistant' percentages indicated that both the offshore and intertidal areas could have received anthropogenic-derived metals, which could be influenced by physico-chemical properties of the sediments. Although the present data indicated that contamination due to Cu and Pb in the west coast of Peninsular Malaysia especially in the offshore areas were not serious, regular biomonitoring studies along the west coast of Peninsular Malaysia are recommended.
Correlations between speciation of Cd, Cu, Pb And Zn in sediment and their concentrations in total soft tissue of green-lipped mussel Perna viridis from the west coast of Peninsular Malaysia

Yap CK, Ismail A, Tan SG, Omar H

Environ Int, 2002 Apr;28(1-2):117-26.
PMID: 12046948

Total concentrations and speciation of cadmium (Cd), copper (Cu), lead (Pb) and zinc (Zn) in surface sediment samples were correlated with the respective metal measured in the total soft tissue of the green-lipped mussel Perna viridis, collected from water off the west coast of Peninsular Malaysia. The aim of this study is to relate the possible differences in the accumulation patterns of the heavy metals in P. viridis to those in the surface sediment. The sequential extraction technique was employed to fractionate the sediment into 'freely leachable and exchangeable' (EFLE), 'acid-reducible,' 'oxidisable-organic' and 'resistant' fractions. The results showed that significant (P .05) was found between Zn in P viridis and all the sediment geochemical fractions of Zn and total Zn in the sediment. This indicated that Zn was possibly regulated from the soft tissue of P. viridis. The present results supported the use of P viridis as a suitable biomonitoring agent for Cd, Cu and Pb.
Fulltext Endoscopic ultrasound-guided hepaticogastrostomy using a partially covered metal stent in patients with malignant biliary obstruction after failed Endoscopic retrograde cholangiopancreatography

Emmanuel J, Omar H, See LT

JGH Open, 2020 Dec;4(6):1059-1064.
PMID: 33319037 DOI: 10.1002/jgh3.12386

BACKGROUND AND AIM: The advent of endoscopic ultrasound-guided biliary drainage (EUS-BD) has provided an inimitable alternative for gaining biliary access in patients who fail conventional endoscopic drainage. The antimigratory features of the partially covered metal stent (PCMS), namely, the flange head and uncovered portion of the stent, makes it a valuable option in patients undergoing EUS-guided hepaticogastrostomy (EUS-HGS). The aim of the study is to evaluate the clinical outcome of EUS-BD via the hepaticogastrostomy approach using PCMS in patients with malignant biliary obstruction after failed ERCP.
METHODS: This is a single-center retrospective observational study of patients with malignant biliary obstruction undergoing EUS-HGS after failed ERCP between January 2018 and May 2019. The end-point of the study was to assess the technical and clinical success rate, as well as the stent- and procedure-related complications.
RESULTS: There were 20 subjects in this study. The average age was 71.8 ± 7.6 years. Most patients were male, 16 (80%). Inaccessible papillae was the most common indication for this procedure, 16 (80%). Technical success was achieved in all patients. The average procedural time was 39.9 ± 1.3 min. Mean preprocedural bilirubin levels were 348.6 ± 28.8 and subsequently decreased to 108.94 ± 37.1 μmol/L at 2 weeks postprocedure. The clinical success rate was 95% (19/20), with one patient requiring percutaneous transhepatic biliary drainage (PTBD). There were no stent- or procedure-related complications reported in this study.
CONCLUSION: EUS-HGS with PCMS is a feasible, effective, and safe alternative for biliary decompression in patients with failed endoscopic retrograde cholangiopancreatography (ERCP).
Discrete flower pollination algorithm for patient admission scheduling problem

Abdalkareem ZA, Al-Betar MA, Amir A, Ehkan P, Hammouri AI, Salman OH

Comput Biol Med, 2022 Feb;141:105007.
PMID: 34785077 DOI: 10.1016/j.compbiomed.2021.105007

This paper aims to tackle the Patient Admission Scheduling Problem (PASP) using the Discrete Flower Pollination Algorithm (DFPA), a new, meta-heuristic optimization method based on plant pollination. PASP is one of the most important problems in the field of health care. It is a highly constrained and combinatorial optimization problem of assigning patients to medical resources in a hospital, subject to predefined constraints, while maximizing patient comfort. While the flower pollination algorithm was designed for continuous optimization domains, a discretization of the algorithm has been carried out for application to the PASP. Various neighborhood structures have been employed to enhance the method, and to explore more solutions in the search space. The proposed method has been tested on six instances of benchmark datasets for comparison against another algorithm using the same dataset. The prospective method is shown to be very efficient in solving any scheduling problem.
Based on Real Time Remote Health Monitoring Systems: A New Approach for Prioritization "Large Scales Data" Patients with Chronic Heart Diseases Using Body Sensors and Communication Technology

Kalid N, Zaidan AA, Zaidan BB, Salman OH, Hashim M, Albahri OS, et al.

J Med Syst, 2018 Mar 02;42(4):69.
PMID: 29500683 DOI: 10.1007/s10916-018-0916-7

This paper presents a new approach to prioritize "Large-scale Data" of patients with chronic heart diseases by using body sensors and communication technology during disasters and peak seasons. An evaluation matrix is used for emergency evaluation and large-scale data scoring of patients with chronic heart diseases in telemedicine environment. However, one major problem in the emergency evaluation of these patients is establishing a reasonable threshold for patients with the most and least critical conditions. This threshold can be used to detect the highest and lowest priority levels when all the scores of patients are identical during disasters and peak seasons. A practical study was performed on 500 patients with chronic heart diseases and different symptoms, and their emergency levels were evaluated based on four main measurements: electrocardiogram, oxygen saturation sensor, blood pressure monitoring, and non-sensory measurement tool, namely, text frame. Data alignment was conducted for the raw data and decision-making matrix by converting each extracted feature into an integer. This integer represents their state in the triage level based on medical guidelines to determine the features from different sources in a platform. The patients were then scored based on a decision matrix by using multi-criteria decision-making techniques, namely, integrated multi-layer for analytic hierarchy process (MLAHP) and technique for order performance by similarity to ideal solution (TOPSIS). For subjective validation, cardiologists were consulted to confirm the ranking results. For objective validation, mean ± standard deviation was computed to check the accuracy of the systematic ranking. This study provides scenarios and checklist benchmarking to evaluate the proposed and existing prioritization methods. Experimental results revealed the following. (1) The integration of TOPSIS and MLAHP effectively and systematically solved the patient settings on triage and prioritization problems. (2) In subjective validation, the first five patients assigned to the doctors were the most urgent cases that required the highest priority, whereas the last five patients were the least urgent cases and were given the lowest priority. In objective validation, scores significantly differed between the groups, indicating that the ranking results were identical. (3) For the first, second, and third scenarios, the proposed method exhibited an advantage over the benchmark method with percentages of 40%, 60%, and 100%, respectively. In conclusion, patients with the most and least urgent cases received the highest and lowest priority levels, respectively.
Based Real Time Remote Health Monitoring Systems: A Review on Patients Prioritization and Related "Big Data" Using Body Sensors information and Communication Technology

Kalid N, Zaidan AA, Zaidan BB, Salman OH, Hashim M, Muzammil H

J Med Syst, 2017 Dec 29;42(2):30.
PMID: 29288419 DOI: 10.1007/s10916-017-0883-4

The growing worldwide population has increased the need for technologies, computerised software algorithms and smart devices that can monitor and assist patients anytime and anywhere and thus enable them to lead independent lives. The real-time remote monitoring of patients is an important issue in telemedicine. In the provision of healthcare services, patient prioritisation poses a significant challenge because of the complex decision-making process it involves when patients are considered 'big data'. To our knowledge, no study has highlighted the link between 'big data' characteristics and real-time remote healthcare monitoring in the patient prioritisation process, as well as the inherent challenges involved. Thus, we present comprehensive insights into the elements of big data characteristics according to the six 'Vs': volume, velocity, variety, veracity, value and variability. Each of these elements is presented and connected to a related part in the study of the connection between patient prioritisation and real-time remote healthcare monitoring systems. Then, we determine the weak points and recommend solutions as potential future work. This study makes the following contributions. (1) The link between big data characteristics and real-time remote healthcare monitoring in the patient prioritisation process is described. (2) The open issues and challenges for big data used in the patient prioritisation process are emphasised. (3) As a recommended solution, decision making using multiple criteria, such as vital signs and chief complaints, is utilised to prioritise the big data of patients with chronic diseases on the basis of the most urgent cases.
Systematic Review of Real-time Remote Health Monitoring System in Triage and Priority-Based Sensor Technology: Taxonomy, Open Challenges, Motivation and Recommendations

Albahri OS, Albahri AS, Mohammed KI, Zaidan AA, Zaidan BB, Hashim M, et al.

J Med Syst, 2018 Mar 22;42(5):80.
PMID: 29564649 DOI: 10.1007/s10916-018-0943-4

The new and ground-breaking real-time remote monitoring in triage and priority-based sensor technology used in telemedicine have significantly bounded and dispersed communication components. To examine these technologies and provide researchers with a clear vision of this area, we must first be aware of the utilised approaches and existing limitations in this line of research. To this end, an extensive search was conducted to find articles dealing with (a) telemedicine, (b) triage, (c) priority and (d) sensor; (e) comprehensively review related applications and establish the coherent taxonomy of these articles. ScienceDirect, IEEE Xplore and Web of Science databases were checked for articles on triage and priority-based sensor technology in telemedicine. The retrieved articles were filtered according to the type of telemedicine technology explored. A total of 150 articles were selected and classified into two categories. The first category includes reviews and surveys of triage and priority-based sensor technology in telemedicine. The second category includes articles on the three-tiered architecture of telemedicine. Tier 1 represents the users. Sensors acquire the vital signs of the users and send them to Tier 2, which is the personal gateway that uses local area network protocols or wireless body area network. Medical data are sent from Tier 2 to Tier 3, which is the healthcare provider in medical institutes. Then, the motivation for using triage and priority-based sensor technology in telemedicine, the issues related to the obstruction of its application and the development and utilisation of telemedicine are examined on the basis of the findings presented in the literature.
Influential factors in stability of lower-limb amputees

Kamali M, Karimi MT, Eshraghi A, Omar H

Am J Phys Med Rehabil, 2013 Dec;92(12):1110-8.
PMID: 23900009 DOI: 10.1097/PHM.0b013e31829b4b7a

Lower-limb amputation is mainly a result of trauma, vascular disease, diabetes, or congenital disorders. Persons with amputation lose their ability to stand and walk on the basis of the level of amputation. Contribution of level of amputation, type of amputation, or cause of amputation to balance impairment has not been clearly defined. Furthermore, it is controversial how much the mentioned parameters influence standing stability. Therefore, the aim of this review article was to find the relationship between the abovementioned factors and balance impairment in the available literature. It was also aimed to find the possibility of improving standing stability by the use of different prosthesis components.

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