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An Online Expert Diagnosis System

A Case Study on Online Medical Diagnosis System

A thesis submitted to the Department of Computer Science, American

International University –Bangladesh (AIUB) in partial fulfillment of the

requirement for the degree of Bachelor of Science in Computer Science and

Engineering.

Siddique Md Sohel ID: 06-06961-2

Uddin Mohammed Rakib ID: 06-06787-2

Rabbi Fazla Chowdhury ID: 06-06665-2

Sarker Mithun ID: 07-08663-2

2



Declaration

This is to certify that this is our original work. No part of this work has been

submitted elsewhere partially or fully for the award of the other degree or

diploma. Any material reproduced in this thesis has been properly

acknowledged.

Student’s Names & Signatures

………………………… …………………………

Siddique Md Sohel Uddin Mohammed Rakib

ID: 06-06961-2 ID: 06-06787-2

……………………….. …………………………

Rabbi Fazla Chowdhury Sarker Mithun

ID: 06-06665-2 ID: 07-08663-2

3



Approval

The thesis titled “ An Online Expert Diagnosis System: A Case Study on

Online Medical Diagnosis System ” has been submitted to the following

respected member of the Board of Examiners of Faculty of Computer Science in

partial fulfillment of the degree for the Bachelor of Science in Computer

Science and Engineering on 24 th May 2010 by the following Students and has

been accepted as satisfactory.

Siddique Md Sohel ID: 06-06961-2

Uddin Mohammed Rakib ID: 06-06787-2

Rabbi Fazla Chowdhury ID: 06-06665-2

Sarker Mithun ID: 07-08663-2

……………………………….. …………………………………

Mr. Md Anwarul Kabir Mr. Md Manirul Islam

Thesis Supervisor & Assistant Professor External & Assistant Professor

Department of Computer Science & Department of Computer Science &

Information Technology Information Technology

AIUB AIUB

…………………………. ………………………………

Prof. Dr. Tafazzal Hossain Dr. Carmen Z. Lamagna

Dean Vice Chancellor

Department of Computer Science & AIUB

Information Technology

AIUB

4



Acknowledgements

It is obvious that carrying out a research on this scope needs the support of

many people. In our work, we have received supports in various forms from

many people from home and abroad.

First of all we would like to thank our supervisor Mr. Anwarul Kabir for his

suggestion and valuable information over the period of this thesis work. His

suggestion helped us to find out an efficient solution. Without his supervision

the thesis would not be completed.

We also like to thank the Head of Computer Science & Information Technology

Department Mr. Mashiour Rahman for his suggestion to fulfill every official

activity regarding our research. Thanks given to Mr. Md Manirul Islam

Lecturer, Department of Computer Science & Information Technology for his

encouragement and suggestions.

We want to give thanks to Prof. Dr. Tafazzal Hossain, Dean, and Department of

Computer Science for his valuable advice throughout our research project. His

suggestions and encouragement in developing a well structured thesis is a road

to complete our venture.

We would also like to express our heartfelt thanks to our honorable Vice

Chancellor Dr. Carmen Z. Lamagna for giving the opportunity to work in a

thesis in the undergraduate study. We must point that over the period of our

undergraduate program we have received tremendous moral and academic

supports from her.

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We also like to express our thanks to the ICDDRB authority and research who

always helped by giving important information. Especially, they help us to

understand Expert Diagnosis System providing relevant information.

At last but not least we would like to thanks our parents. Without their moral

and financial support we wouldn’t able to complete our research.

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Contents

Page No.

Declaration

Approval

Acknowledgement

Contents

Abstract

Chapter 1 Introduction

1.1 Introduction

Chapter 2 Literature View

Chapter 3 Software Technology Used In Our System

Chapter 4 System Planning & Design

Chapter 5 Implementation & Description

Chapter 6 Limitation & Conclusion

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Abstract

Online Expert Diagnosis System (OEDS) is knowledge based expert system.

The major objective of OEDS is to diagnosis Acute Appendicitis, Acute

Cholecystitis and Acute Pancreatitis diseases. The system is also capable of

saving data in its database and updating the Knowledge Base (KB) in

accordance with information received from different patients.

In implementing OEDS, we have followed online expert system technology and

so, we have acquired knowledge from a relevant specialist doctor. Thisknowledge has been represented in the system’s KB. For diagnosis, we have

implemented an Inference Engine (IE) which has the ability of inference by

using the stored knowledge in the KB. This IE carries the relevant data about

patient (supplied from each patient session) and following logical approach it

interacts with the KB and comes to a conclusion about disease. This system has

also tried to capture the heuristic knowledge of the doctor. For this, the IE hasfollowed the statistical method to reach to a conclusion.

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Chapter 1

Introduction

1.1 Introduction

This Chapter represents the overall view of our thesis projects. This chapter

mainly focuses on the importance of implementing An Online Expert Diagnosis

System on Online medical diagnosis System. The title of proposed project has

been mentioned here. Objective and scopes section has pointed out the overallobjective and scopes of the project. For implementing the system we have

proposed a knowledge based (KB) system. In this chapter we have also tried to

present the structure of our proposed system.

1.2 Title of the Thesis

An Online Expert Diagnosis System

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1.3 Objective and scopes

The major objective of the thesis is to design and a quick, simple and efficient

method for diagnosis Expert system using state of the art technology. For this,

we are considering to follow the structure of the expert system paradigm

Artificial Intelligence. The sub-objectives of this thesis are stated below:

• Acquiring Knowledge from a relevant physician.

• Creating a knowledge Base (KB).

• Representing the acquire knowledge into KB using appropriate

algorithm.

• Providing friendly user interface.

1.4 Rationale

In Bangladesh, at present, most of the doctors mainly use manual way through

their observation, experience along with various reports (e.g. X-rays, ECG) for

diagnosing disease. But if they use our proposed system then they can easily be

able to diagnose different varieties of diseases efficiently and accurately without

consuming much time. So, if the doctors use this system then they can easily

trace the disease. The proposed system will not only manage a new patient'sinformation but also it will able to extract an old patient's information. As a

result when a patient visits a doctor’s chamber after two or three years the

doctor can find out his/her history easily. So it will be very helpful for the

doctors. Moreover it also increases the efficiency of diagnosing the diseases.

By using this system doctors can predict information about diseases.

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1.5 An Overview of proposed system

The proposed Online Expert Diagnosis System (OEDS) will be knowledge

based expert system for diagnosing diseases. Our system will also save the data

for future purpose. For this we have analyzed many reports on Acute

Appendicitis, Acute Cholecystitis and Peptic Ulcer and took interview to

explore how doctors take history of a patient and what criteria they follow to

diagnosing a disease.

We have also tried to understand what the first stage of diagnosing is and whatthe final stage of it is. We have analyzed and built a database based on doctor’s

diagnosing techniques of real time. Then we have learned to enrich the database

which relevant knowledge. This database will act as knowledge base future

system. We gave knowledge to our system according to those criteria. At first

the doctor needs to be registered himself as user and approved by an admin. If

the patient is completely new then the system does the clinical test for the patient in that session. It will ask some questions and after testing the system

will take decision whether there is any problem or not. If problem found then

we give some pathological Test. We gave our system enough knowledge on

different types of disease. The system will have a flexible interactive interface.

The system will act the relevant questions about his/her diseases and will store

the answers in its working memory. Based on the patient’s answer, interfaceensure of the system will communicate with the knowledge base and

subsequently will diagnosing the diseases.

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1.6 Structure of the Thesis

A brief description of the chapters included in this report is given below:

In second chapter entitled “Literature view” focuses on different issues of

relevant disease. It will also discuss on Expert systems and how its usage in

medical science.

The Third chapter entitled “Software tools and Technology used in Expert

diagnosis system”. In this chapter will discuss the tools used for implements thissystem and will try to justify the selected of those tools.

The fourth chapter entitled “Planning and designing” mainly consists of

software planning, flow of data, software context and different software

designing diagrams.

The Fifth chapter “Implementation and Description” describes the

implementing method of the system. It also discusses on some critical parts of

the system and its implementation.

Finally, the sixth chapter is the concluding chapter. This chapter discusses the

achievement of this thesis. It also includes some possible future enhancement of the system.

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Chapter 2

Literature View

2.1 Introduction

This chapter contains the literature review of our project and thesis. A brief

analysis of expert system using different technologies is mainly described in

this chapter. In this literature review chapter we actually focused on the Expertsystem which is a computer based program that simulates the judgments and

behavior of a human. We not only describe about expert system but also discuss

about various aspects that are related to our project and thesis such as

knowledge base, inference engine, working procedure of inference engine.

2.2 Expert System

An expert system is a computer application that solves complicated problems

that would otherwise require extensive human expertise. To do so, it simulates

the human reasoning process by applying specific knowledge and interfaces. It

is known to all that books and manual guides have a tremendous amount of knowledge but a human has to read and interpret the knowledge for it to be

used. For this reason expert systems also use human knowledge to solve

problems that normally would require human intelligence. Actually expert

systems represent the expertise knowledge as data or rules within the computer

as a result when we need any kind of assist to solve any type of problems we

can easily find out from the knowledge base. References of source and book:

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2.3 Knowledge Base

In general, a knowledge base is a centralized repository for information where

public libraries, a database of related information about a particular subject all

are considered to be examples of knowledge base. In relation to information

technology, a knowledge base is a machine readable resource for the

dissemination of information, generally on online or with the capacity to be put

on online. Moreover an integral component of knowledge management systems

indicates that a knowledge base is generally used to optimize information

collection, association, and retrieve data for various purposes. On the other hand computer User High-Tech Dictionary defines the knowledge-based system

as a computer system which is usually programmed to imitate human problem-

solving by means of artificial intelligence and reference to a database of

knowledge on a particular subject. Moreover Knowledge-based (KB) systems

are type of systems that base on the methods and techniques of Artificial

Intelligence where the core components are the knowledge base and theinference mechanisms. [2]

If we consider some author’s expert system opinion then we can see that

knowledge-based systems are the combination of case-based reasoning systems

and neural networks, on the contrary a few author's expert systems define that

neural networks are different, and for this reason they exclude it from thiscategory.

14



2.4 Inference Engine

In the language of computer science, specifically the undergrowth of knowledge

engineering and artificial intelligence, an inference engine is a computer

program that tries to derive answers from a knowledge base. It is actually work

as a "brain" which is used by our EDS to motive information in the knowledge

base (KB) for the ultimate purpose of formulating new conclusions. In addition

Inference engines are considered to be a special case of reasoning engines,

which can use more general methods of interpretation.

Ho w the inference engine works?In simple rule-based systems, there are two kinds of inference, forward chaining

and backward chaining.

Figure: Block Diagram for an Expert System

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2.4.1 Forward chaining

In forward chaining data generally put into the working memory. This triggers

rules whose first condition is to match the new data. After matching the data

these rules then perform their actions. The actions may add new data to

memory, thus triggering more rules. And so on. This is also called data-directed

inference, because inference is triggered by the arrival of: the data in working

memory. [3]

2.4.2 Backward chaining

In backward chaining, the system needs to know the value of a piece of data. It

searches for rules whose conclusions mention this data. Before it can use the

rules, it must test their conditions. This may entail discovering the value of

more pieces of data, and so on. This is also called goal-directed inference, or hypothesis driven, because inferences are not performed until the system is

made to prove a particular goal. [3]

2.5 Description on Disease

Acute is the abrupt onset, in reference to a disease. Acute often also connotes

an illness that is of short duration, rapidly progressive, and in need of urgent

care.

"Acute" is a measure of the time scale of a disease and is in contrast to "sub

Acute" and "Chronic." "Sub Acute" indicates longer duration or less rapid

change. "Chronic" indicates indefinite duration or virtually no change.

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In this system we work with the three Acute diseases such as:

1. Acute Appendicitis,

2. Acute Cholecystitis,

3. Acute Pancreatitis.

2.5.1 Appendicitis

The appendix is a closed-ended, narrow tube up to several inches in length

that attaches to the cecum (the first part of the colon) like a worm. (Theanatomical name for the appendix, vermiform appendix, means worm-like

appendage.) The inner lining of the appendix produces a small amount of

mucus that flows through the open center of the appendix and into the cecum.

The wall of the appendix contains lymphatic tissue that is part of the immune

system for making antibodies. Like the rest of the colon, the wall of the

appendix also contains a layer of muscle, but the layer of muscle is poorlydeveloped.

Appendicitis means inflammation of the appendix. It is thought that

appendicitis begins when the opening from the appendix into the cecum

becomes blocked. The blockage may be due to a build-up of thick mucus

within the appendix or to stool that enters the appendix from the cecum. Themucus or stool hardens, becomes rock-like, and blocks the opening. This rock

is called a fecalith (literally, a rock of stool). At other times, the lymphatic

tissue in the appendix might swell and block the appendix. After the blockage

occurs, bacteria which normally are found within the appendix begin to

invade (infect) the wall of the appendix. The body responds to the invasion by

mounting an attack on the bacteria, an attack called inflammation.

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http://www.medicinenet.com/script/main/art.asp?articlekey=10347






2.5.1.1 Acute Appendicitis

As Acute appendicitis is an inflammation of the appendix, a 3 1/2-inch-long

tube of tissue that extends from the large intestine. No one is absolutely

certain what the function of the appendix is. One thing we do know: We can

live without it, without apparent consequences.

Appendicitis is a medical emergency that requires prompt surgery to remove

the appendix. Left untreated, an inflamed appendix will eventually burst, or

perforate, spilling infectious materials into the abdominal cavity. This can

lead to peritonitis, a serious inflammation of the abdominal cavity's lining (the peritoneum) that can be fatal unless it is treated quickly with strong

antibiotics.

2.5.1.2 Acute Appendicitis Causes

Appendicitis is one of the most common causes of emergency abdominal

surgery in the United States. It usually occurs when the appendix becomes

blocked by feces, a foreign object, or rarely, a tumor .

2.5.1.2 Acute Appendicitis Symptoms

The symptoms of appendicitis vary. It can be hard to diagnose appendicitis in

young children, the elderly, and women of childbearing age.

Typically, the first symptom is pain around your belly button. (See: Abdominal

pain ) The pain may be vague at first, but becomes increasingly sharp

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http://www.nlm.nih.gov/medlineplus/ency/article/001310.htm








and severe. You may have reduced appetite, nausea, vomiting, and a

low-grade fever.

As the inflammation in the appendix increases, the pain tends to move into your

right lower abdomen and focuses directly above the appendix at a place

called McBurney's point .

If your appendix ruptures, the pain may lessen briefly and you may feel better.

However, once the lining of your abdominal cavity becomes inflamed

and infected (a condition called peritonitis ), the pain gets worse and you

become sicker.

Your abdominal pain may be worse when walking or coughing. You may prefer

to lie still because sudden movement causes pain.

Later symptoms include:

Chills

Constipation

Diarrhea

Fever

Loss of appetite

Nausea

Shaking

Vomiting

2.5.2 Cholecystitis

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Cholecystitis is inflammation of the gallbladder, usually resulting from a

gallstone blocking the cystic duct.

• Gallbladder inflammation usually results from a gallstone blocking the

flow of bile.

• Typically, people have abdominal pain that lasts more than 6 hours,

fever, and nausea.

• Ultrasonography can usually detect signs of gallbladder inflammation.

• The gallbladder is removed, often using a laparoscope.

Cholecystitis is the most common problem resulting from gallbladder stones. It

occurs when a stone blocks the cystic duct, which carries bile from the

gallbladder.

2.5.2.1 Acute Cholecystitis

Acute Cholecystitis begins suddenly, resulting in severe, steady pain in the

upper abdomen. At least 95% of people with Acute Cholecystitis have

gallstones. The inflammation almost always begins without infection, although

infection may follow later. Inflammation may cause the gallbladder to fill with

fluid and its walls to thicken.

Rarely, a form of Acute Cholecystitis without gallstones (AcalculousCholecystitis) occurs. Acalculous Cholecystitis is more serious than other types

of Cholecystitis. It tends to occur after the following:

• Major surgery

• Critical illnesses such as serious injuries, major burns and body wide

infections (sepsis)

• Intravenous feedings for a long time

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• Fasting for a prolonged time

• A deficiency in the immune system

It can occur in young children, perhaps developing from a viral or another

infection.

Figure 4.2: Acute Cholecystitis

2.5.2.1 Acute Cholecystitis Symptoms

A gallbladder attack, whether in Acute or Chronic Cholecystitis, begins as pain.

The pain of Cholecystitis is similar to that caused by gallstones (biliary colic) but is more severe and lasts longer—more than 6 hours and often more than 12

hours. The pain peaks after 15 to 60 minutes and remains constant. It usually

occurs in the upper right part of the abdomen. The pain may become

excruciating. Most people feel a sharp pain when a doctor presses on the upper

right part of the abdomen. Breathing deeply may worsen the pain. The pain

often extends to the lower part of the right shoulder blade or to the back. Nausea

and vomiting are common.

QuickTime™ and adecompressor

are needed to see this picture.

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Within a few hours, the abdominal muscles on the right side may become rigid.

Fever occurs in about one third of people with Acute Cholecystitis. The fever

tends to rise gradually to above 100.4° F (38° C) and may be accompanied by

chills. Fever rarely occurs in people with Chronic Cholecystitis.

In older people, the first or only symptoms of Cholecystitis may be rather

general. For example, older people may lose their appetite, feel tired or weak, or

vomit. They may not develop a fever.

Typically, an attack subsides in 2 to 3 days and completely resolves in a week.If the Acute episode persists, it may signal a serious complication. A high fever,

chills, a marked increase in the white blood cell count, and cessation of the

normal rhythmic contractions of the intestine (ileus—see Gastrointestinal

Emergencies: Appendicitis ) suggest pockets of pus (abscesses) in the abdomen

near the gallbladder from gangrene (which develops when tissue dies) or a

perforated gallbladder.

If people develop jaundice (see Manifestations of Liver Disease: Jaundice ) or

pass dark urine and light-colored stools, the common bile duct is probably

blocked by a stone, causing a backup of bile in the liver (Cholecystitis).

Inflammation of the pancreas (Pancreatitis) can develop. It is caused by a stone

blocking the Ampulla of water, near the exit of the pancreatic duct.

Acalculous Cholecystitis typically causes sudden, excruciating pain in the upper

abdomen in people with no previous symptoms or other evidence of a

gallbladder disorder. The inflammation is often very severe and can lead to

gangrene or rupture of the gallbladder. In people with other severe problems

(including people in the intensive care unit for another reason), acalculous

Cholecystitis may be overlooked at first. The only symptoms may be a swollen

22

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http://www.merck.com/mmhe/sec10/ch135/ch135b.html



http://www.merck.com/mmhe/sec10/ch135/ch135b.html



(distended), tender abdomen or a fever with no known cause. If untreated,

Acalculous Cholecystitis results in death for 65% of people.

23



2.5.3 Pancreatitis

Pancreatitis is inflammation of the pancreas. The pancreas is a large gland

behind the stomach and close to the duodenum – the first part of the small

intestine. The pancreas secretes digestive juices, or enzymes, into the duodenum

through a tube called the pancreatic duct. Pancreatic enzymes join with bile – a

liquid produced in the liver and stored in the gallbladder – to digest food. The

pancreas also releases the hormones insulin and glucagon into the bloodstream.

These hormones help the body regulate the glucose it takes from food for

energy.

Normally, digestive enzymes secreted by the pancreas do not become active

until they reach the small intestine. But when the pancreas is inflamed, the

enzymes inside it attack and damage the tissues that produce them.

Pancreatitis can be Acute or Chronic. Either form is serious and can lead tocomplications. In severe cases, bleeding, infection, and permanent tissue

damage may occur.

2.5.3.1 Acute Pancreatitis

Acute pancreatitis is inflammation of the pancreas that occurs suddenly and

usually resolves in a few days with treatment. Acute pancreatitis can be a life-

threatening illness with severe complications. Each year, about 210,000 people

in the United States are admitted to the hospital with Acute pancreatitis. The

most common cause of Acute pancreatitis is the presence of gallstones—small,

pebble-like substances made of hardened bile—that cause inflammation in the

pancreas as they pass through the common bile duct. Chronic, heavy alcohol use

24



is also a common cause. Acute pancreatitis can occur within hours or as long as

2 days after consuming alcohol. Other causes of Acute pancreatitis include

abdominal trauma, medications, infections, tumors, and genetic abnormalities of

the pancreas.

QuickTime™ and adecompressor

are needed to see this picture.

Figure 4.3: Acute Pancreatitis

2.5.3.2 Acute Pancreatitis Causes

The pancreas is an organ located behind the stomach that produces chemicals

called enzymes, as well as the hormones insulin and glucagon. Most of the time,

the enzymes are only active after they reach the small intestine, where they are

needed to digest food.

When these enzymes somehow become active inside the pancreas, they eat (and

digest) the tissue of the pancreas. This causes swelling, bleeding (hemorrhage),

and damage to the pancreas and its blood vessels.

25



Acute pancreatitis affects men more often than women. Certain diseases,

surgeries, and habits make you more likely to develop this condition.

The condition is most often caused by alcoholism and alcohol abuse (70% of

cases in the U.S.). Genetics may be a factor in some cases. Sometimes the cause

is not known, however.

Other conditions that have been linked to pancreatitis are:

• Autoimmune problems (when the immune system attacks the body)• Blockage of the pancreatic duct or common bile duct, the tubes that

drain enzymes from the pancreas

• Damage to the ducts or pancreas during surgery

• High blood levels of a fat called triglycerides (hypertriglyceridemia)

• Injury to the pancreas from an accident

Other causes include:

• Complications of cystic fibrosis

• Hemolytic uremic syndrome

• Hyperparathyroidism

• Kawasaki disease

• Reye syndrome

• Use of certain medications (especially estrogens, corticosteroids,

thiazide diuretics, and azathioprine)

• Viral infections, including mumps, coxsackie B, mycoplasma

pneumonia, and campylobacter.

26



2.5.3.3 Acute Pancreatitis Symptoms

The most common symptom of Acute pancreatitis is pain. Almost everybody

with Acute pancreatitis experiences pain.

• The pain may come on suddenly or build up gradually. If the pain

begins suddenly, it is typically very severe. If the pain builds up

gradually, it starts out mild but may become severe.

• The pain is usually centered in the upper middle or upper left part of

the belly (abdomen). The pain may feel as if it radiates through to the

back.

• The pain often begins or worsens after eating.

• The pain typically lasts a few days.

• The pain may feel worse when a person lies flat on his or her back.

People with Acute pancreatitis usually feel very sick. Besides pain, people may

have other symptoms.

• Nausea (Some people do vomit, but vomiting does not relieve the

symptoms.)

• Fever, chills, or both

• Swollen abdomen which is tender to the touch

27



• Rapid heartbeat (A rapid heartbeat may be due to the pain and fever,

or it may be a compensation if a person is bleeding internally.)

In very severe cases with infection or bleeding, a person may become

dehydrated and have low blood pressure, in addition to the following symptoms:

• Weakness or feeling tired (fatigue)

• Feeling lightheaded or faint

• Lethargy

• Irritability

• Confusion or difficulty concentrating

• Headache

If the blood pressure becomes extremely low, the organs of the body do not get

enough blood to carry out their normal functions. This very dangerous condition

is called circulatory shock or is referred to simply as shock.

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Chapter 3

Software Technology Used In Our System

3.1 Introduction

In this thesis various types of components and equipments have been used. We

have used some software tools and hardware tools to complete this project and

thesis successfully. This chapter provides a brief description of some important

components which are used in this project and thesis and as a result this system becomes much more user Friendly especially for the doctor.

3.2 DOT NET FRAMEWORK

The Microsoft .NET Framework is a software technology that is available with

several Microsoft Windows operating systems. It includes a large library of pre-

coded solutions to common programming problems, a runtime or virtual

machine that manages the execution of programs written specifically for the

framework, and a set of tools for configuring and building applications. The

.NET Framework is a key Microsoft offering and is intended to be used by mostnew applications created for the Windows platform.

Programs written for the .NET Framework execute in a software environment

that manages the program's runtime requirements. Also part of the .NET

Framework, this runtime environment is known as the Common Language

Runtime (CLR). The CLR provides the appearance of an application virtual

machine so that programmers need not consider the capabilities of the specific

29



CPU that will execute the program. The CLR also provides other important

services such as security, memory management, and exception handling. The

class library and the CLR together compose the .NET Framework.

The .NET Framework is included with Windows Server 2008 and

Windows Vista. The current version of the framework can also be installed on

Windows XP and the Windows Server 2003 family of operating systems. A

reduced "Compact" version of the .NET Framework also available on

Windows Mobile platforms, including Smart phones. Some characteristicsof .NET Framework are as follows:

• Interoperability

• Common Runtime Engine

• Language Independence

• Base Class Library

• Simplified Deployment

• Security

• Portability

• The ability to make the entire range of computing devices work

together and to have user information automatically updated and

synchronized on all of them

• Increased interactive capability for Web sites, enabled by greater use

of XML (Extensible Markup Language) rather than HTML

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• A premium online subscription service, that will feature customized

access and delivery of products and services to the user from a central

starting point for the management of various applications, such as e-

mail, for example, or software, such as Office NET

• Centralized data storage, which will increase efficiency and case of

access to information, as well as synchronization of information

among users and devices

• The ability to integrate various communications media, such as e-mail,faxes, and telephones

• For developers, the ability to create reusable modules, which should

increase productivity and reduce the number of programming errors.

3.3 ASP .NET

ASP.NET is a web application framework developed and marketed by

Microsoft that programmers can use to build dynamic web sites, web

applications and web services. It was first released in January 2002 with version

1.0 of the NET Framework, and is the successor to Microsoft's Active Server

Pages (ASP) technology. ASP.NET is built on the Common Language

Runtime, allowing programmers to write ASP.NET code using any supported

_NET language.

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3.3.1 Pages

ASP.NET pages, known officially as "web forms", are the main building

block for application development. Web forms are contained in files with an

ASPX extension; in programming jargon, these files typically contain static

HTML or XHTML markup, as well as markup defining server-side Web

Controls and User Controls where the developers place all the required static

and dynamic content for the web page. Additionally, dynamic code which runs

on the server can be placed in a page within a block <% ---dynamic code ---%>

which is similar to other web development technologies such as PHP, JSP, andASP, but this practice is generally discouraged except for the purposes of data

binding since it requires more calls when rendering the page.

3.3.2 Code behind Model

It is recommended by Microsoft for dealing with dynamic program code to use

the code-behind model, which places this code in a separate file or in a specially

designated script tag. Code-behind files typically have names like

diagnosis.aspx.cs or diagnosis.aspx based on the ASPX file name (this practice

is automatic in Microsoft Visual Studio and other IDLs). When using this style

of programming, the developer writes code to respond to different events, likethe page being loaded, or a control being clicked, rather than a procedural walk

through the document.

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3.3.3 User Controls

ASP.NET supports creating reusable components through the creation of User

Controls. A user Control follows the same structure as a Web Form, except that

such controls are derived from the system.Web.UI.UserControl class,

and are stored in ASCX files. Like ASPX files, an ASCX contains static

HTML or XHTML markup, as well as markup defining web controls and other

User Controls. The code-behind model can be used.

Programmers can add their own properties, methods, and event handlers. An

event bubbling mechanism provides the ability to pass an event fired by a user

control up to its containing page.

3.3.4 Session state

Session state is a collection of user-defined session variables, which are persisted during a user session. These variables are unique to different instances

of a user session, and are accessed using the session collection. Session

variables can be set to be automatically destroyed after a defined time of

inactivity, even if the session does not end. At the client end a user session is

identified either by a cookie or by encoding the session ID in the URL itself.

3.3.5 Directory Structure

In general, the ASP.NET directory structure can be determined by the

developer's preferences. Apart from a few reserved directory names, the site can

span any number of directories. The structure is typically reflected directly in

the URLs. Although ASP.NET provides means for intercepting the request at

33



any point during processing, the developer is not forced to funnel requests

through a central application or front controller.

The special directory names (from ASP.NET 2.0 on) are:

App_Browsers:

Holds site specific browser definition files.

App_Code:

This is the "raw code" directory. The ASP.NET server will automatically

compile files (and subdirectories) in this folder into an assembly which is

accessible in the code of every page of the site. App Code will typically be used

for data access abstraction code, model code and business code. Also any site-specific http handlers and modules and web service implementation go in this

directory. As an alternative to using App Code the developer may opt to provide

a separate assembly with precompiled code.

App_Data

It is a default directory for databases, such as Access .mdb files and SQL Server

.mdf files. This directory is usually the only one with write access for the

application. App LocalResources Contains localized resource files for

individual pages of the site. E.g. a file called Checlc0ut.aspx.fr-FR.resx holds

localized resources for the French version of the CheckOut.aspx page. When the

34



UI culture is set to French, ASP.NET will automatically find and use this file

for localization.

App_GlobalResources

This folder holds . rcsx files with localized resources available to every page of

the site. This is where the ASP.NIJT developer will typically store localized

messages etc. which are used on more than one page.

App_WebReferences

In this folder discovery files and WSDL files for references to web services to

be consumed in the site.

Bin:

It contains compiled code (All files) for controls, components, or other code that

you want to reference in our application. Any classes represented by code in the

Bin folder are automatically referenced in our application.

3.3.6 Performance

ASP.NET aims for performance benefits over other script-based technologies

(including Classic ASP) by compiling the server-side code to one or more DLL

files on the web server. This compilation happens automatically the first time a

page is requested (which means the developer need not perform a separate

compilation step for pages). This feature provides the ease of development

offered by scripting languages with the performance benefits of a compiled

35



binary. However, the compilation might cause a noticeable delay to the web

user when the newly-edited page is first requested from the web server.

The ASPX and other resource files are placed in a virtual host on an Internet

Information Services server (or other compatible ASP.NET servers; see Other

Implementations, below). The first time a client requests a page, the NET

framework parses and compiles the file(s) into a.NCT assembly and sends the

response; subsequent requests are served from the DLL tiles. By default

ASP.NET will compile the entire site in batches of 1000 files upon first request.

If the compilation delay is causing problems, the batch size or the compilationstrategy may be tweaked.

Developers can also choose to pre-compile their code before deployment,

eliminating the need for just-in-time compilation in a production environment.

3.4 SQL SERVER

Microsoft SQL Server is a relational database management system (RDBMS)

produced by Microsoft. Its primary query language is Transact-SQL, an

implementation of the ANSI/ISO Standard Structured Query Language (SQL)

used by both Microsoft and Sybase. [12]

3.4.1 Architecture

The architecture of Microsoft SQL Server is broadly divided into three

components: SQLOS which implements the basic services required by SQL

Server, including thread scheduling, memory management and I/O

36



management; the Relational Engine, which implements tile relational database

components including support for databases, tables, queries and stored

procedures as well as implementing the type system; and the Protocol Layer

which exposes the SQL Server functionality.

3.4.2 Relational Engine

The Relational engine implements the relational data store using the capabilities

provided by SQLOS, which is exposed to this layer via the private SQLOS API.It implements the type system, to define the types of the data that can be stored

in the tables, as well as the different 1~ypes of data items (such as tables,

indexes, logs etc) that can be stored. It includes the Storage Engine, which

handles the way data is stored on persistent storage devices and provides

methods for fast access to the data. The storage engine implements log-based

transaction to ensure that any changes to the data are ACID compliant. It alsoincludes the query processor, which is the component that retrieves data. SQL

queries specify what data to retrieve, and the query processor optimizes and

translates the query into the sequence of operations needed to retrieve the data.

The operations are then performed by worker threads, which are scheduled for

execution by SQLOS.

3.4.3 Data Storage

The main unit of data storage is a database, which is a collection of tables with

typed columns. SQL Server supports different data types, including primary

types such as Integer, Float, Decimal, Char (including character strings),

Varchar (variable length character sn-ings), binary (for unstructured blobs of

37



data), Text (for textual data) among others. It also allows user-defined

composite types (UDTs) to be defined and used. SQL Server also makes server

statistics available as virtual tables and views (called Dynamic Management

Views or DMVs). A database can also contain other objects including views,

stored procedures, indexes and constraints, in addition to tables, along with a

transaction log. An SQL Server, database can contain a maximum of 231

objects, and can span multiple OS-level files with a maximum file size of 220

TB. The data in the database are stored in primary data files with an

extension .mdf. Secondary data files, identified with an .ndf extension, are used

to store optional metadata. Log files are identified with the .ldf extension.

3.4.4 Data Retrieval

The main mode of retrieving data from an SQL Server database is querying for

it. The query is expressed using a variant of SQL called T-SQL, a dialectMicrosoft SQL Server shares with Sybase SQL Server due to its legacy. The

query declaratively specifics what is to be retrieved. It is processed by the

query processor, which figures out the sequence of steps that will be necessary

to retrieve the requested data. The sequence of actions necessary to execute a

query is called a query plan. There might be multiple ways to process the same

query. For example, for a query that contains a joint statement and a selectstatement, executing join on both the tables and then executing select on

the results would give the same result as selecting from each table and then

executing the join, but result in different execution plans. In such case, SQL

Server chooses the plan that is supposed to yield the results in the shortest

possible time. This is called query optimization and is performed by the query

processor itself.

38



3.5 Reason for using ASP C# and SQL Server Database

C# is an object oriented language. In our system we have used different classes

and their objects. We used Visual studio2008 as IDE. It's an excellent IDE for

rapid application development. It has a very user friendly environment for

software development. This IDE provide built in SQL server database service.

More over from the above discussion of this chapter we can realize that ASP

technology with C# programming language and SQL server database is the best

choice as software technology of our system.

39



Chapter 4

System Planning & Design

4.1 Introduction

This chapter represents the basic description of the proposed Expert System. In

this chapter we actually focus on the planning and designing part which is

divided into four stages. They are:

1. System Architecture.

2. Use Case Diagram.

3. Entity Relationship Diagram

4. Knowledge Base Structure.

Finally in this chapter we discuss about the artificial intelligence whichindicates inference Engine that represents forward chaining and backward

chaining of this system.

4.2 System’s Architecture

Our system has followed the structure of a standard Expert System as shown in

the figure

4. 1. So, for our system we have planned to build a knowledge base (KB),

Inference Engine (IE) and Input-Output Interfaces.

40



Figure 4.1: Structure of Expert System

41



The Following Diagram depict our overall system plan

42



43



Figure 4.2: System Structure

4.3 Components of this System

44



Components of this expert system are given below:

1. Administrator’s Site

2. Doctor’s

3. Knowledge Base

4. Database for SE

5. Diagnosis

a. Basic Diagnosis

b. Clinical Diagnosis

1. Relevant Symptoms Selection

2. Generate Questionnaire3. Add new Symptom

c. Recommendation for Test

1. White Blood Cell Count

2. City Scan gallbladder size

3. Endoscope bile duct stone

4. Red Blood Cell count etc.d. Pathological Test

1. Blood test

1. White Blood Cell Count

2. Red Blood Cell Count

3. Serum Analysis

4. Serum Lipase5. Urine

2. Imaging

1. Gallbladder Size

2. Gall Stone

3. Bile Duct Stone

3. Hematocrit

4. Hemoglobin

45



5. Bilirubin

e. Confirm Diseases percentages

f. Write Prescription

1. Suggested medicine

2. Add new medicine

3. Remove Medicine

4. Medicine dose each day

5. Medicine duration to use

g. Print Result.

4.4 Major Constraints

Any Software based constraints will impact the manner in which the software is

to be specified, designed, implemented or tested. The software is specified for

An Online Expert Diagnosis System on Disease.

Developing tools:

Software Technology:

1. Microsoft visual studio 20082. ASP.NET

3. Language: C#

4. Microsoft SQL Server 2005.

Hardware:

46



1. Computer

2. Printer

3. Server

4.5 Functional Element

4.5.1 Use case List

• Create Doctor

• Admin/Doctor Login

• Verification

• Add new Patient/Search existing Patient

• See Patient Old Result

• Check Basic Test

• Show Basic Test Result

• Check Clinical Test with Dynamic Symptom and Questionnaire

• Suggest For Test

• Check Pathological Test

• Check Blood

• Check Urine

• Check Imaging

•

Suggest medicine• Display Final Result

• Print Result

4.6 User Groups (Admin + Doctor)

47



4.6.1 Role of Administrator

• Create new Administrator user account

• Create new Doctor Account

• View User Data

• Monitor User Activity

• Activate User

• Deactivate user

• Block User

4.6.2 Role of Doctor

• Main User of our System

• Add new patient

• Search Existing patient

•

Check Patient Basic Test• Check Patient Clinical Test

• Check Patient Pathological Test

• Finally decide the diseases with system and doctor decision

• Prescribe Medicine

• Print Result

48



4.7 Use Case Diagram

The Use Case diagram consists of five very simple graphics that represent

the System, Actors, Use Cases, Associations, and dependencies of the

project. The goal of the diagram is to provide a high-level explanation of the

relationship between the system and the outside world.

System: Sets the boundary of the system in relation to the actors who use it

(outside the system) and the features it must provide (inside the system).

Actor: A role played by a person or system that has a stake in the successful

operation of the system. Example: administrator, counter manager, user etc.

Use Case: Identities a key feature of the system. Without these features,

the system will not fulfill the user/actor requirements. Each Use Case expresses

a goal that the system must achieve.

49



Figure 4.3: Use Case Diagram for Online Expert Diagnosis System

50



4.8 Entity Relationship Diagram

51



52



Figure 4.4: Entity Relationship(ER) Diagram of Online Expert Diagnosis System

4.9 Knowledge Base Structure

53



Figure 4.5: knowledge base structure

4.10 Description of Tables

54



4.10.1 tblDoctor Profile

This is doctors table. An admin can create a doctor. It contains doctor name,

address, contact, chamber, sex, specialty, Degree, Hospital, email, Username.

Using username a doctor can login in our system. And specialty means a patient

can choose his right doctor for his disease problem; As a result he can’t run

more doctors.

4.10.2 tblPatientProfile

55



This is patient table. This table will be created by doctors. It contains name,

address, id, contact, dob, age, sex, email, doctor, image. Patient age will be

calculated by entry data-date of birth.

4.10.3 tblLogin

This is login table. This table uses by both Doctor and admin. It contains

username, password, type, status, lastaccess, code, create time, passreset. Here

type means which user login now admin or doctor. Status means user is active

or deactive if doctor are not use our expert diagnosis system. Code is when a

doctor applies for use our system then we sends an email with generates a secret

56



code. When he put this value in our code field then doctor account is active in

our system and this is Create time.

4.10.4 tblTest

This is test table. It contains test id, test name, test description and test for. This

table keeps test history for different disease. As a result, new doctor learn which

test is suitable for different disease.

4.10.5 tbltocken

This is knowledge base table. In this table we keep symptom keyword. If new

disease is come than we match keyword for find desired disease.

4.10.6 tblSymptom

57



This is symptom table. It is uses for clinical diagnosis. It contains symptom id,

symptom category, symptom sequence, symptom Caption, symptom value,Question id, id. We know every disease has different symptom. So, we use

symptom id for catch the specific disease. For supporting tools we use also

symptom category, sequence. Caption use for resulting the correct disease

because same symptom has different disease so distinguish them we use

caption. Value is a specific symptom rate. Using this value we find the desired

disease by calculating probability Rate. If highest probability is found then wesure that this patient has this disease.

58



4.10.7 tblPathology

This is

pathology table. This table generate after clinical disease result. It contains

patient internal information like blood, urine, serum, wbc, rbc, hematocrit,

hemoglobin, bilirubin, ct scan, ultrasound, endoscopy result. It also keeps

previous internal information. After given all input than it calculates the input

value that is r_val and from r_val it shows the probability of all disease. And

result is show the correct disease that disease has highest probability value.

4.10.8 tblDisease

59



This is basic disease table. It contains the different disease so we use disease id.

For this disease id we use also disease name, type, description and category.

4.10.9 tblDiagnosisRecord

This table saves all previous disease record with symptom. As a result, a doctor

can decide which disease can occur now.

60



4.10.10 tblMedicine

This is Medicine table. Use this table a doctor can easily decide which medicine

is better for specific disease. This table contains Medicine id, name, type, value,

hit, manufacture, for, effect, extract. Hit use for medicine rating. If expert

doctor use specific medicine than hit counter will increase than a new doctor

can easily decide that this medicine is useful for this disease.

4.10.11 tblMedication

61



This table used for prescription. A Doctor can suggest medicine with quantity of

medicine, doses. This information saves in this table.

4.10.12 tblQuestion

This is question table. It is contain all symptom of different disease. This table

create dynamic generated question after the Clinical symptom table.

4.10.13 tblPhysicalInfo

This table uses for basic diagnosis. When a patient come to the doctor than

doctor check her pulse, Blood pressure, Body temperature, pain, anemia and

skin color.

4.10.14 tblUser

62



This is user management table.

4.11 Inference Engine

Inference Engine discusses the criteria of queries for the system which give

emphasis on some critical queries. We have used both forward and backward

chaining in our system. When the system gets a new data from the doctor it

check the data from the knowledge base and if it matches with a rule which wasgenerated from the knowledge base and take decision accordingly. After that

the data is saved for future purpose. For example all the data for different

Clinical Tests have saved in the database. If any value for the given test type is

Greater than the normal range than it will take decision from the knowledge

which has stored in the database. A doctor can also give his/her own comment

for the Test. All the data is stored in the database for future purpose.

63



Chapter 5

Implementation & Description

5.1 Introduction

This Project contains all the necessary information about the Expert diagnosis

system on various diseases. This is very much helpful for a user to find out

about disease. This chapter describes the different parts and pages of theimplementation of the software.

5.2 Basic steps of working

This is the chapter which implements the entire software of this project andalso tries to find out how this software works in all stages. Here is some

description of this steps are available on EDS.

64



5.2.1 Home Page

Figure 5.1 Home page of Expert Diagnosis System

This is the figure of our home page. Since our project name is Expert Diagnosis

System on Acute Pancreatitis, Appendicitis and Cholesitis. Our system

differentiates these three diseases when doctor confused to indicate which

diseases exactly. Automatically we have to provide a Login page where users

65



that can be an Administrator or a doctor have to give his/her user name and

password. After verifying the user name and password our system will give the

permission to go further.

5.2.2 Doctor/Admin Log In

Figure 5.2 Admin Log In

This is a figure of Admin/Doctor login page. From the login page doctor can

add/search patient and then can diagnosis that patient. After login doctor can

manage or create user. Admin can also activate, deactivate or block e user.

5.2.3 Password Reset or Forget

Figure 5.3 Password forgets or reset.

66



Password can reset by proving old password. Forget Password can be reset by

providing security code that is sending to mail account.

5.2.4 Doctor Create

Figure 5.3 User Create

In our system admin can create a doctor or a doctor can join as doctor by

providing his/her information. Then admin review and verify his/her

account. If account contains correct data then admin activate his/her account.

On registration a security code also send to his/her account to verify his mail

id. On registration doctor info saves on tblDoctorprofile n this table has e

relation with tblLogin.

67



5.2.4 Account Activation by automatic system generated security code via

mail.

Figure 5.5 Account activation via mail

When a doctor account is created then our system send an automatic mail to his

mail id with an activation link. After putting that security numbers on our system

interface (that given below) his/her account will activated for use.

Figure 5.6 Enter security code from mail for activation

68



Figure 5.6 welcome message after activation

After activating account by entering security code from mail a confirmation

message is send to his/her account as welcome message. The user can use

his/her account for farther processing.

69



5.2.5 Adding New Patient

Figure 5.7 Patient Adding by doctor

Doctor can add new patient by providing patient info. And a patient needs to

add to diagnosis his physical condition. Patient data will be saving on

tblPatientprofile table.

5.2.7 Search Patient:

70



Figure 5.8 Search Existing Patient

Doctor can search existing patient by using patient Name, ID or Doctor’s

Name and result will published on figure below.

Figure 5.8 Search Existing Patient

71



After clicking on find patient our system will show detail info of that patient for

farther processing like-name, id, address, contact, email, sex, age, doctor etc.

5.2. Doctor’s Information

Figure 5.9 Doctor Profile

72



Doctor can view or edit his/her information by clicking on “ My Profile ” Link

from right side of main interface. Doctor info include image, name, address,

contact date of birth, chamber, hospital, specialty, user name and email address

etc.

5.2.8 Patient Information

Figure 5.9 Patient information

73



After clicking on view patient system will show his/her detail and previous

diseases information. Like diseases name, basic test result, clinical test result,

pathological result and percentages of diseases.

5.2.9 Basic Information

Figure 5.10 Patient Basic Tests

74



From the interface top a doctor can check a patient basic test by putting pulse,

blood pressure range, body temperature, anemia, skin color etc.

5.2.10 Basic Result

Figure 5.10 patient basic tests

After submitting patient basic information our system will provide a general

test result based on patient basic info. Basic include pulse, blood pressure,

temperature, pain, anemia, jondish etc.

75



5.2.11 Clinical Diagnosis

Figure 5.10 Dynamic symptom

On clinical test our system will generate some relevant symptom on

pancreatitis, appendicitis and Cholecystitis. System also have an option to add

new symptom that may be able to arise on doctor mind, we add that symptom

on our database by matching with token. After math with a token that symptom

will listed finally for next time use with weight value.

76



5.2.10 Clinical test Dynamic Questions

Figure 5.11 Dynamic Questions

This is automatically generated question based on patient clinical test symptom

selection. After submitting this questions system will provide a clinical test

result for farther processing.

77



5.2.11 Clinical Result with suggested pathological test

Figure 5.11 Clinical test results with suggested pathological test

After submitting dynamic questions system will redirect to result with

suggested pathological test. Results include diseases name and total

probability of diseases. Suggestion include some pathological test like- White

blood cell count, CT scan Gallbladder Size, Endoscope Bile duct Stone, Red

Blood Cell Count etc.

78



5.2.12Pathological Test

Figure 5.11 pathological test

In pathological test doctor will check patient report by using interface above.

Pathological Test include Serum analyze, Serum Lipase,24 Urine, White

blood Cell count, Red Blood Cell count, Imaging, Gallbladder size, Gall

stone, Bile Duct Stone, Hematocrit, Hemoglobin, Bilrubin etc.

79



5.2.13Pathological Test Result

Figure 5.11 pathological tests Result

In Pathological Test Result our system provides a final result of diseases

percentage that is based on pathological test and clinical test. If the percentage

is between (45-49) then our system suggest to re test. If Result is more than

50 percent then our system suggests that diseases may be able to occur. Or if

the result is less than 45 percent then our system suggests “ You should

contact with the other specialist ”.

80



5.2.14Prescribe Medicine

Figure 5.12 Prescribe Medicine

This is last interface of our system that provides an option to doctor to

write/suggest prescription of require medicine. If the required medicine not

available for suggest then doctor can add new medicine that will store for

future use and also for current patient. When doctor will add new medicine

then he/she can provide medicine name, medicine power, dose, days etc.

81



5.2.15 Patient Old Records

Figure 5.13 Patient Old Records

In Patient old records include patient previous diagnosis results that help

doctor to decide farther processing. It also help patient. When patient forget to

carry his previous prescription then he/she can see his/her previous result

from our system by help of doctor.

82



5.3 Knowledge Base Implementation

5.3.1 For Basic Test

In basic system take patient basic info like pulse rate, blood pressure range,

body temperature, any pain in body, anemia, skin color. After provide these

info our system provide a result that help doctor to see about patient initial

physical condition.

The sample code is given below:

public partial class patient_basicresult : System.Web.UI. Page

{

protected void Page_Load( object sender, EventArgs e)

{

EntityUser user = ( EntityUser )Session[ "user" ];

if (Session[ "user" ] != null ){

lblPulse.Text = Pulse();

lblBp.Text = BP();

lblTemparature.Text = Temparature();

lblpain.Text =

(( EntityPatient )Session[ "patient" ]).Pain;

lblAnemia.Text = Anemia();

lblSkin.Text = Skin();

}

else

{

Response.Redirect( "~/application/login/loginuser.a

spx" );

83



}

}

private String Pulse()

{

String result = "" ;

if ((( EntityPatient )Session[ "patient" ]).Pulse ==

"Below 60" )

{

result = "Tachycardia" ;

}

else if ((( EntityPatient )Session[ "patient" ]).Pulse ==

"60-90" )

{

result = "Normal" ;

}

else if ((( EntityPatient )Session[ "patient" ]).Pulse ==

"Above 90" ){

result = "dradycardia" ;

}

return result;

}

private String BP()

{


if ((( EntityPatient )Session[ "patient" ]).Bp ==

"Systolic(>140)& Diastolic(>100)" )

{

result = "High Pressure" ;

}

84

else if ((( EntityPatient )Session[ "patient" ]).Bp ==

"Systolic(100-140)& Diastolic(60-100)" )

{

result = "Normal" ;

}

else if ((( EntityPatient )Session[ "patient" ]).Bp ==

"Systolic(<100)& Diastolic(<60)" )

{

result = "Low Pressure" ;

}

return result;

}

private String Temparature()

{


if ((( EntityPatient )Session[ "patient" ]).Temperature =="Below 98.6" )

{

result = "Hypthermia" ;

}

else if

((( EntityPatient )Session[ "patient" ]).Temperature == "98.6" )

{result = "Normal" ;

}

else if

((( EntityPatient )Session[ "patient" ]).Temperature == "Above

98.6" )

{

result = "Hyterthermia" ;

85



}

return result;

}

private String Anemia()

{


if ((( EntityPatient )Session[ "patient" ]).Anemia ==

"White at lower Congunetiva" ||

(( EntityPatient )Session[ "patient" ]).Anemia == "White at the

finger end" || (( EntityPatient )Session[ "patient" ]).Anemia ==

"Both of them" )

{

result = "May be.Have to test glucose" ;

}

else if ((( EntityPatient )Session[ "patient" ]).Anemia ==

"None of them" )

{result = "No" ;

}

return result;

}

private String Skin(){


if ((( EntityPatient )Session[ "patient" ]).Skin ==

"Blue" )

{

result = "May be.Have to test blood" ;

}

86



else if ((( EntityPatient )Session[ "patient" ]).Skin ==

"Normal" )

{

result = "No" ;

}

return result;

}

protected void btnGo_Click( object sender, EventArgs e)

{

Response.Redirect( "../patient/diagnosis_new.aspx" );

}

}

5.3.2 For Clinical Test Dynamic Questionnaires

In clinical test our system generate come dynamic question that is based on

pancreatitis, appendicitis, cholesitis. If doctor found some other symptoms

from patient that is not available on our system then doctor can add that

symptom by clicking on add other. And that symptom will be added in our

database by matching token. This symptom can be used in future.


public partial class diagnosis_new : System.Web.UI. Page

{


{

EntityUser user = ( EntityUser ) Session[ "user" ];

EntityPatient patient = ( EntityPatient )

Session[ "patient" ];

87

if (Session[ "user" ] != null )

{

if (!Page.IsPostBack)

{

Load_all_sym();

if (Session[ "patient" ] != null )

{

lblPatientName.Text = "Patient :" +

(( EntityPatient ) Session[ "patient" ]).Name;

}

}

}

else

{


spx" );

}}

private bool checkentry()

{

foreach ( ListItem lst in CheckBoxList1.Items)

if (lst.Selected) return true ;





return false ;

88



}

protected void Button1_Click( object sender, EventArgs e)

{

if (!checkentry()) return ;

clsDataRet pan;

clsDataRet app;

clsDataRet col;

clsDataRet com;

string max = "" ;

com = getforcommon( ref CheckBoxList4, "COM");

pan = getselitem( ref CheckBoxList1, "PAN" ,

com.SelVal);

app = getselitem( ref CheckBoxList2, "APP" ,

com.SelVal);col = getselitem( ref CheckBoxList3, "COL" ,

com.SelVal);

if (pan.SelVal > app.SelVal)

{

if (pan.SelVal > col.SelVal)

{max = "pan" ;

}

else

{

max = "col" ;

}

}

89



else

{

if (app.SelVal > col.SelVal)

{

max = "app" ;

}

else

{

max = "col" ;

}

}

Session[ "pan" ] = pan;

Session[ "app" ] = app;

Session[ "col" ] = col;

Session[ "com" ] = com;

Session[ "max" ] = max;

if (Response != null )

Response.Redirect( "~/application/patient/default2.aspx" );

}

private void Load_all_sym()

{load_by_cat( ref CheckBoxList1, "PAN" );

load_by_cat( ref CheckBoxList2, "APP" );

load_by_cat( ref CheckBoxList3, "COL" );

load_by_cat( ref CheckBoxList4, "COM");

}

90



private clsDataRet getforcommon( ref CheckBoxList chk,

string category)

{

tblSymptomTableAdapter sym = new

tblSymptomTableAdapter ();

string [] tmp;

clsDataRet ret = new clsDataRet ();

double cnt = 0;

ret.SelItm = "" ;

foreach ( ListItem lst in chk.Items)

{

if (lst.Selected)

{

tmp = lst.Value.Split( ':' );

cnt += Convert .ToDouble(tmp[1]);ret.SelItm += tmp[0] + "," ;

}

}

return ret;

}

private clsDataRet getselitem( ref CheckBoxList chk, string

category, double comval)

{



string [] tmp;

91




double tot =

Convert .ToDouble(sym.GetTolVal(category));

double cnt = 0;

ret.SelItm = "" ;


{

if (lst.Selected)

{


cnt += Convert .ToDouble(tmp[1]);

ret.SelItm += tmp[0] + "," ;

}

}

ret.SelVal += comval;

ret.SelVal = 100*cnt/tot;

return ret;

}

private void load_by_cat( ref CheckBoxList chk, string

category)

{ tblSymptomTableAdapter sym = new


dtsMedical . tblSymptomDataTable dt = new

dtsMedical . tblSymptomDataTable ();

ListItem lst;

dt = sym.GetDataByCat(category);

chk.Items.Clear();

92



foreach ( dtsMedical . tblSymptomRow dr in dt.Rows)

{

lst = new ListItem ();

lst.Text = dr.sym_caption;

lst.Value = dr.sym_id.ToString() + ":" +

dr.sym_value.ToString();

chk.Items.Add(lst);

}

}

protected void CheckBox1_CheckedChanged( object sender,

EventArgs e)

{

if (CheckBox1.Checked)

{

TextBox1.Text = "" ;

TextBox1.Visible = true ;

Button2.Visible = true ;

} else

{

TextBox1.Visible = false ;

Button2.Visible = false ;

}

}


{

int maxsl, maxcatsl;

int iapp, icol, ipan, maxint;

string max = "" ;

tblTokenTableAdapter tok = new tblTokenTableAdapter ();

93



dtsMedical . tblTokenDataTable dt = new

dtsMedical . tblTokenDataTable ();

tblQuestionsTableAdapter ques = new

tblQuestionsTableAdapter ();



dt = tok.GetData();

iapp = getcnt(dt[0].tokapp);

icol = getcnt(dt[0].tokcol);

ipan = getcnt(dt[0].tokpan);

if (ipan > iapp)

{

if (ipan > icol)

{

max = "PAN" ;maxint = ipan;

}

else

{

max = "COL" ;

maxint = icol;

}}

else

{

if (iapp > icol)

{

max = "APP" ;

maxint = iapp;

}

94



else

{

max = "COL" ;

maxint = icol;

}

}

maxsl = ( int ) sym.GetMaxSl() + 1;

maxcatsl = ( int ) sym.GatMaxCatSl(max) + 1;

sym.InsertQuery(maxsl.ToString(), max, maxcatsl,

TextBox1.Text, (maxint*5).ToString());

ques.Insert(maxsl.ToString(), 1, "High" );

ques.Insert(maxsl.ToString(), 2, "Medium" );

ques.Insert(maxsl.ToString(), 3, "Low" );


Button2.Visible = false ;CheckBox1.Checked = false ;

Load_all_sym();

}

private int getcnt( string str)

{

string [] tmp, tmp2; int i = 0;

tmp = str.Split( ',' );

tmp2 = TextBox1.Text.Split( ' ' );

foreach ( string s1 in tmp)

{

foreach ( string s2 in tmp2)

95



{

if ((s1.Trim() == s2.Trim()) && (s1.Trim() !=

"" ))

{

i++;

goto next;

}

}

next:

;

}

return i;

}

}

5.3.3 For clinical Test

In case of clinical test the system take blood pressure, pulse rate and some

physical symptom and it check with the knowledge given to it. After checking it

determine whither is there any problem or not and display comment according

to the problem. After providing the result the system saves the data in the

database. The user interface already given in the previous part.


public partial class application_Default2 : System.Web.UI. Page

{

protected void Page_Load( object sender, EventArgs e){

96



load_q();

}

private void load_q()

{

string max,val1,val2;

clsDataRet pan, app, col, com;

pan = ( clsDataRet )Session[ "pan" ];

app = ( clsDataRet )Session[ "app" ];

col = ( clsDataRet )Session[ "col" ];

com = ( clsDataRet )Session[ "com" ];

max = Session[ "max" ].ToString() ;

getfromstr(pan.SelItm);

getfromstr(app.SelItm);getfromstr(col.SelItm);

getfromstr(com.SelItm);

txtPathology.Visible = false ;

Label2.Visible = false ;

}

private void getfromstr( string str)

{

string [] tmp;


foreach ( string itm in tmp) { if (itm != "" )getq(itm);

}

}

97



private void getq( string sid)

{



dtsMedical . tblSymptomDataTable dtsym = new


tblQuestionsTableAdapter ques = new


dtsMedical . tblQuestionsDataTable dt = new

dtsMedical . tblQuestionsDataTable ();

RadioButtonList rdo = new RadioButtonList ();

// ListItem lst;

Label lb;

dtsym = sym.GetDataByid(sid);

if (dtsym.Rows.Count == 0) return ;

dt = ques.GetDataBySym(dtsym[0].ques_id);

rdo.Items.Clear();

foreach ( dtsMedical . tblQuestionsRow dr in dt.Rows)

{

rdo.Items.Add(dr.questions);

}

if (rdo.Items.Count > 0)

{

lb = new Label ();

98



lb.Text= "*" + dtsym[0].sym_caption;

lb.ID = dtsym[0].ques_id.ToString();

PlaceHolder1.Controls.Add(lb);

PlaceHolder1.Controls.Add(rdo);

}

}


{

tblDiagonosisRecordTableAdapter dia = new

tblDiagonosisRecordTableAdapter ();



txtPathology.Visible = true ;

Label2.Visible = true ;

clsDataRet pan, app, col, com;

pan = ( clsDataRet )Session[ "pan" ];

app = ( clsDataRet )Session[ "app" ];

col = ( clsDataRet )Session[ "col" ];

com = ( clsDataRet )Session[ "com" ];

string maxpoint;

PlaceHolder1.Visible = false ;




if (Session[ "max" ].ToString().ToUpper() == "APP" )

99

{

String res = "Disease Acute Appendicitis, Total

Probability = " ;

String res2 = "Disease Acute Choleysities, Total

Probability = " ;

String res3 = "Disease Acute Pancreatitis, Total

Probability = " ;

String dis = "Acute Appendicitis" ;

Label1.Text = res + app.SelVal.ToString( "N2" );

EntityMedicine med = new

BLLPrescription ().SuggestPathology(dis);

for ( int i = 0; i < med.Tests.Length;i++)

{

txtPathology.Text = txtPathology.Text +

med.Tests[i] + "\n" ;

}

Session.Add( "result2" , "Acute Choleysities" );

Session.Add( "r_val2" , col.SelVal.ToString( "N2" ));

Session.Add( "result" , dis);

Session.Add( "r_val" , app.SelVal.ToString( "N2" ));

Session.Add( "result3" , "Acute Pancreatitis" );

Session.Add( "r_val3" , pan.SelVal.ToString( "N2" ));

Button2.PostBackUrl = "Test_Pan.aspx" ;

maxpoint=app.SelVal.ToString( "N2" );

}

else if (Session[ "max" ].ToString().ToUpper() == "COL" )

{

String res = "Disease Acute Choleysities, Total

Probability =" ;

100

String res2 = "Disease Acute Appendicitis, Total

Probability = " ;

String res3 = "Disease Acute Pancreatitis, Total

Probability = " ;

String dis = "Acute Choleysities" ;

Label1.Text = res + col.SelVal.ToString( "N2" );



for ( int i = 0; i < med.Tests.Length; i++)

{



}


Session.Add( "r_val" , col.SelVal.ToString( "N2" ));

Session.Add( "result2" , "Acute Appendicitis" );Session.Add( "r_val2" , app.SelVal.ToString( "N2" ));

Session.Add( "result3" , "Acute Pancreatitis" );

Session.Add( "r_val3" , pan.SelVal.ToString( "N2" ));


maxpoint=col.SelVal.ToString( "N2" );

} else

{

String res = "Disease Acute Pancreatitis, Total

Probability =" ;

String res2 = "Disease Acute Choleysities, Total

Probability =" ;

String res3 = "Disease Acute Appendicitis, Total

Probability = " ;

101

String dis = "Acute Pancreatitis" ;

Label1.Text = res + pan.SelVal.ToString( "N2" );



for ( int i = 0; i < med.Tests.Length; i++)

{



}


Session.Add( "r_val" , pan.SelVal.ToString( "N2" ));

Session.Add( "result2" , "Acute Appendicitis" );

Session.Add( "r_val2" , app.SelVal.ToString( "N2" ));

Session.Add( "result3" , "Acute Choleysities" );Session.Add( "r_val3" , col.SelVal.ToString( "N2" ));


maxpoint=pan.SelVal.ToString( "N2" );

}

int pid = (( EntityPatient ) Session[ "patient" ]).Id;

if (dia.GetDataBy1(pid).Rows.Count == 0){

dia.InsertQuery(pid, pan.SelItm, app.SelItm,

col.SelItm, com.SelItm, Session[ "max" ].ToString().ToUpper(),

maxpoint, DateTime .Now,

(( EntityUser )Session[ "user" ]).Username,

(( EntityUser )Session[ "user" ]).Name);

}

else

102



{

dia.InsertQuery(pid, pan.SelItm, app.SelItm,

col.SelItm, com.SelItm, Session[ "max" ].ToString().ToUpper(),

maxpoint, DateTime .Now,

(( EntityUser )Session[ "user" ]).Username,

(( EntityUser )Session[ "user" ]).Name);

}

//save entry

}

}

103



5.3.3 Pathological Test

Pathological test is the final face of patient diagnosis. Pathological test

confirm that which disease may have patient. Pathological test exually

percentage based result. Pathological Test include Serum analyze, Serum

Lipase,24 Urine, White blood Cell count, Red Blood Cell count, Imaging,

Gallbladder size, Gall stone, Bile Duct Stone, Hematocrit, Hemoglobin,

Bilrubin etc. If the percentage is between (45-49) then our system suggest to

re test. If Result is more than 50 percent then our system suggests that

diseases may be able to occur. Or if the result is less than 45 percent then our system suggests “You should contact with the other specialist”.


public partial class application_Default2 : System.Web.UI. Page

{


{

pnlResult.Visible = false ;

if (Session[ "user" ] == null )

{


spx" );

}

else if (Session[ "patient" ] == null )

{

Response.Redirect( "~/application/patient/findpatie

nt.aspx" );

}

}

protected void btnSave_Click( object sender, EventArgs e)

104



{

EntityPathology pathology = new EntityPathology ();

pnlResult.Visible = true ;

pathology.Bilirubin = ddlBilirubin.SelectedValue;

pathology.Blood = ddlBloodSample.SelectedValue;

pathology.DocName = (( EntityUser )

Session[ "user" ]).Name;

pathology.Hematocrit = ddlHematocrit.SelectedValue;

pathology.Hemoglobin = ddlHemoglobin.SelectedValue;

pathology.PatID = (( EntityPatient )

Session[ "patient" ]).Id;

pathology.Rbc = ddlRedBloodCell.SelectedValue;

pathology.Serum = ddlSerumLipase.SelectedValue;

pathology.Urine = ddlUrinSample.SelectedValue;

pathology.Username = (( EntityUser )

Session[ "user" ]).Username;

pathology.Wbc = ddlWhiteBloodCell.SelectedValue;

pathology.CtScan =ddlImagingGallbladder.SelectedValue;

pathology.UltraSound =

ddlImagingGallStone.SelectedValue;

pathology.Endoscopy =

ddlImagingBileDuct.SelectedValue;

pathology.Result = (( String )Session[ "result" ]);

pathology.RVal = (( String )Session[ "r_val" ]);

Session.Add( "pathology" , pathology);

int i = BLLPathology .InsertValue(pathology);

Check();

}

105

private void Check()

{

EntityPathology path = (( EntityPathology )

Session[ "pathology" ]);

String str = "Above" ;

if (path.Bilirubin == str || path.Blood == str ||

path.Hematocrit == str || path.Hemoglobin == str || path.Rbc

== str || path.Serum == str || path.Urine == str || path.Wbc

== str || path.UltraSound == "Found" || path.CtScan ==

"Increase" || path.Endoscopy == "Found" )

{

//float x = (Session["r_val"]);

//Response.Write(x);

if ( Convert .ToDouble(( String )Session[ "r_val" ]) >=

50)

{

lblRes.Text = "" +

(( String )Session[ "result" ]).ToString() + " " +

(( String )Session[ "r_val" ]) + " Confirm." ;}

else if

( Convert .ToDouble(( String )Session[ "r_val" ]) < 49 &&

Convert .ToDouble(( String )Session[ "r_val" ]) >= 45)

{

lblRes.Text = "" +

(( String )Session[ "result" ]).ToString() + " " +(( String )Session[ "r_val" ]) + " So the system is confused that

the patient have this disease or not." ;

}

else

{

lblRes.Text = "You should contact with the

other specialist." ;

}

106

}

else

{

lblRes.Text = "You should contact with the

other specialist." ;

}

}

protected void btnPrescribe_Click( object sender, EventArgs

e)

{

Response.Redirect( "../patient/prescribe.aspx" );

}

}

5.3.4 Prescribe Medicine

In prescribe medicine doctor can suggest required medicine to patient that is

available. If the required medicine is not available for suggest then doctor canadd new medicine that will store for future use and also for current patient.

When doctor will add new medicine then he/she can provide medicine name,

medicine power, dose, days etc.


public partial class diagnosis_new :

System.Web.UI. Page

{

protected void Page_Load( object sender, EventArgs

e)

{

107

EntityUser user = ( EntityUser )

Session[ "user" ];

EntityPatient patient = ( EntityPatient )

Session[ "patient" ];

if (Session[ "user" ] != null )

{

if (!Page.IsPostBack)

{

Load_all_sym(); if (Session[ "patient" ] != null )

{

lblPatientName.Text = "Patient

:" + (( EntityPatient ) Session[ "patient" ]).Name;

}

}

}

else

{

Response.Redirect( "~/application/login/lo

ginuser.aspx" );

}

}

private bool checkentry()

{



108







return false ;

}

protected void Button1_Click( object sender,

EventArgs e)

{

if (!checkentry()) return ;

clsDataRet pan;

clsDataRet app;

clsDataRet col;

clsDataRet com;

string max = "" ;

com = getforcommon( ref CheckBoxList4, "COM");

pan = getselitem( ref CheckBoxList1, "PAN" ,

com.SelVal);

app = getselitem( ref CheckBoxList2, "APP" ,

com.SelVal);

109



col = getselitem( ref CheckBoxList3, "COL" ,

com.SelVal);

if (pan.SelVal > app.SelVal){

if (pan.SelVal > col.SelVal)

{

max = "pan" ;

}

else{

max = "col" ;

}

}

else

{

if (app.SelVal > col.SelVal)

{

max = "app" ;

}

else

{

max = "col" ;

}

}

Session[ "pan" ] = pan;

Session[ "app" ] = app;

Session[ "col" ] = col;

110



Session[ "com" ] = com;

Session[ "max" ] = max;

if (Response != null )

Response.Redirect( "~/application/patient/default2.asp

x" );

}

private void Load_all_sym()

{load_by_cat( ref CheckBoxList1, "PAN" );

load_by_cat( ref CheckBoxList2, "APP" );

load_by_cat( ref CheckBoxList3, "COL" );

load_by_cat( ref CheckBoxList4, "COM");

}

private clsDataRet getforcommon( ref CheckBoxList

chk, string category)

{



string [] tmp;


double cnt = 0;

ret.SelItm = "" ;

111




{

if (lst.Selected)

{tmp = lst.Value.Split( ':' );

cnt += Convert .ToDouble(tmp[1]);

ret.SelItm += tmp[0] + "," ;

}

}

return ret;

}

private clsDataRet getselitem( ref CheckBoxList

chk, string category, double comval)

{



string [] tmp;


double tot =

Convert .ToDouble(sym.GetTolVal(category));

double cnt = 0;

ret.SelItm = "" ;


{

112



if (lst.Selected)

{


cnt += Convert .ToDouble(tmp[1]);ret.SelItm += tmp[0] + "," ;

}

}

ret.SelVal += comval;

ret.SelVal = 100*cnt/tot;

return ret;

}

private void load_by_cat( ref CheckBoxList chk,

string category)

{



dtsMedical . tblSymptomDataTable dt = new


ListItem lst;

dt = sym.GetDataByCat(category);

chk.Items.Clear();

foreach ( dtsMedical . tblSymptomRow dr in

dt.Rows)

{

lst = new ListItem ();

lst.Text = dr.sym_caption;

113



lst.Value = dr.sym_id.ToString() + ":" +

dr.sym_value.ToString();

chk.Items.Add(lst);

}}

protected void CheckBox1_CheckedChanged( object

sender, EventArgs e)

{

if (CheckBox1.Checked){

TextBox1.Text = "" ;

TextBox1.Visible = true ;


}

else

{



}

}

protected void Button2_Click( object sender,

EventArgs e)

{

int maxsl, maxcatsl;

int iapp, icol, ipan, maxint;

string max = "" ;

114



tblTokenTableAdapter tok = new

tblTokenTableAdapter ();

dtsMedical . tblTokenDataTable dt = new

dtsMedical . tblTokenDataTable (); tblQuestionsTableAdapter ques = new




dt = tok.GetData();

iapp = getcnt(dt[0].tokapp);

icol = getcnt(dt[0].tokcol);

ipan = getcnt(dt[0].tokpan);

if (ipan > iapp)

{

if (ipan > icol)

{

max = "PAN" ;

maxint = ipan;

}

else

{

max = "COL" ;

maxint = icol;

}

}

115



else

{

if (iapp > icol)

{max = "APP" ;

maxint = iapp;

}

else

{

max = "COL" ;maxint = icol;

}

}

maxsl = ( int ) sym.GetMaxSl() + 1;

maxcatsl = ( int ) sym.GatMaxCatSl(max) + 1;

sym.InsertQuery(maxsl.ToString(), max,

maxcatsl, TextBox1.Text, (maxint*5).ToString());

ques.Insert(maxsl.ToString(), 1, "High" );

ques.Insert(maxsl.ToString(), 2, "Medium" );

ques.Insert(maxsl.ToString(), 3, "Low" );



CheckBox1.Checked = false ;

Load_all_sym();

116



}

private int getcnt( string str)

{ string [] tmp, tmp2;

int i = 0;


tmp2 = TextBox1.Text.Split( ' ' );

foreach ( string s1 in tmp)

{

foreach ( string s2 in tmp2)

{

if ((s1.Trim() == s2.Trim()) &&

(s1.Trim() != "" ))

{

i++;

goto next;

}

}

next:

;

}

return i;

}

}

117



Chapter 6

Limitation & Conclusion

6.1 Introduction

Expert diagnosis system on myocardial infarction can be very useful for the

doctors. This chapter discusses recent attempts to codify knowledge through

the development of expert systems on myocardial infraction. This chapter

argues that in the context of expert systems there is some knowledge that can be

codified. Some for which this is partly possible, and some for which it is

basically impossible given the state of today's technology. We also discuss in

this chapter about the achievements i.e. what the thing we have acquired from

this project and the type of problems we face in this project.

6.2 Achievements

We work hard to implement An Online Expert Diagnosis System. While doing

this project we achieved lots of things. It was a group project. So we learnt how

to work in a group. We also learnt different software technologies like Asp.net,

SQL server database, expert system, Inference engine, heart disease, knowledge

base etc. We also meet different doctors and took their interview. It was

completely a different type of experience for us.

118



6.3 Limitat ions of the Systems

Even though we have tried our best to fix as many issues as possible within the

Expert Diagnosis System it still has some limitations as given below:

• Has not sufficient knowledge about heart disease. So this system may

not provide 100% accurate diagnosis.

• The reason behind this we had some meetings with the concerned

doctors to capture knowledge from him, we believe more meetings we

should have with him to gather more knowledge with a view to enrich

the knowledge base of the system.

6.4 Possible Future Enhancements

As this system is not actually fully implemented so the actual implementation

can be done in future. Few extra features can be added with this Expert

System like:• After gathering huge amount of data, Data mining technique can be

applied for better prediction.

• More disease information can be added for more diagnosis.

• More analysis can be done to improve performance.

6.5 Conclusion

So far, we have succeeded to design and implement the system using ASP C#

on .NET environment. After implementation we have shown the system to

concerned doctor. He has shown positive impression and confirmed that this

system will be a helpful tool in diagnosing relevant diseases. This system will

be an excellent idea for this country. The use of such a system will save time for

119



both the doctor and patients. However, it takes much effort to implementing

this system initially but after that it will be a great beneficial for this country.

Moreover this system can manage the patient relevant information and history

of heart disease.

120



6.6 References

1. [Hobler, K. (Spring 1998). "Acute and Suppurative Appendicitis: Disease

Duration and its Implications for Quality Improvement" ([dead link ] – Scholar

search ). Permanente Medical Journal

2. http://xnet.kp.org/permanentejournal/spring98pj/Spring98.pdf#page=7 .

3. http://en.wikipedia.org/wiki/Appendicitis

4. http://en.wikibooks.org/wiki/Expert_Systems

5. http://en.wikipedia.org/wiki/Requirements_analysis

6. http://www.outsource2india.com/software/RequirementAnalysis.asp

7. http://www.softwareqatest.com/qatweb1.html

8. http://easydiagnosis.com/cgi-bin/expert/start.cgi?mod=Depression

9. http://www.ehow.com/about_5845467_expert-used-health-care-

administration.html

10.http://www.it.bton.ac.uk/staff/lp22/CS237/CS237MedicalXSys.html

11.http://matrixcognition.com/ORIGIN02.HTM

121

http://xnet.kp.org/permanentejournal/spring98pj/Spring98.pdf#page=7


http://en.wikipedia.org/wiki/Wikipedia:Linkrot

http://scholar.google.co.uk/scholar?hl=en&lr=&q=author%3AHobler+intitle%3AAcute+and+Suppurative+Appendicitis%3A+Disease+Duration+and+its+Implications+for+Quality+Improvement&as_publication=Permanente+Medical+Journal&as_ylo=1998&as_yhi=1998&btnG=Search



http://en.wikipedia.org/wiki/Appendicitis

http://en.wikibooks.org/wiki/Expert_Systems

http://en.wikipedia.org/wiki/Requirements_analysis



http://en.wikipedia.org/wiki/Wikipedia:Linkrot




http://en.wikipedia.org/wiki/Appendicitis

http://en.wikibooks.org/wiki/Expert_Systems

http://en.wikipedia.org/wiki/Requirements_analysis



12.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1307157/

13.http://www.computer.org/portal/web/csdl/doi/10.1109/MS.2005.155

14.http://freemind.sourceforge.net/wiki/index.php/Main_Page

15.http://www.opensourcescripts.com/dir/ASP/

oeds book(just print)

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