Automatic Optic Disc Abnormality Detection in Fundus Images: A Deep Learning Approach

Optic disc (OD) is a key structure in retinal images. It serves as an indicator to detect various diseases such as glaucoma and changes related to new vessel formation on the OD in diabetic retinopathy (DR) or retinal vein occlusion. OD is also essential to locate structures such as the macula and the main vascular arcade. Most existing methods for OD localization are rule-based, either exploiting the OD appearance properties or the spatial relationship between the OD and the main vascular arcade. The detection of OD abnormalities has been performed through the detection of lesions such as hemorrhaeges or through measuring cup to disc ratio. Thus these methods result in complex and inflexible image analysis algorithms limiting their applicability to large image sets obtained either in epidemiological studies or in screening for retinal or optic nerve diseases. In this paper, we propose an end-to-end supervised model for OD abnormality detection. The most informative features of the OD are learned directly from retinal images and are adapted to the dataset at hand. Our experimental results validated the effectiveness of this current approach and showed its potential application

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Leber′s miliary aneurysms

Leber′s disease is a form of primary retinal telangiectasia characterized by the presence of abnormalities in the retinal vasculature. It is an idiopathic, unilateral condition with male predilection. It is not associated with any other systemic or ocular disease. The disease has a very slow progression and can be complicated by vascular dilatations, neovascularizations, thromboses, retrovitreal hemorrhages, and macular changes. We present a case of Leber′s miliary aneurysms in an asymptomatic 22-year-old male patient. His fundus examination showed aneurysmal dilatations with lipid exudation. Intravenous fluorescein angiography showed early and late leakage as well as capillary dropout with late hypofluorescence. In this case, the patient was treated with laser photocoagulation of the retina

Idiopathic choroidal neovascular membrane in a young female

A case of idiopathic choroidal neovascular membrane (CNVM) is described in a 17-year-old female patient. On initial examination her vision was counting fingers at one meter in the left eye (OS) and Fluorescein angiography showed a well-defined hyperfluorescent area corresponding to the CNVM. Intravitreal bevacizumab was injected into OS, and at a five-week follow-up visit, visual acuity improved to 20/100 OS. This case is unusual, in that the CNVM developed in a young lady with no significant past medical history and with the absence of a choroidal or retinal pigment epithelial disease process that may be associated with a CNVM

Adaptive handover control parameters over voronoi-based 5G networks

Various speed scenarios such as high-speed travelling trains and connected drones over ultra-dense heterogeneous networks (HetNets) may result in a large number of handovers (HOs), which may cause further mobility challenges. Therefore, mobility robustness optimization (MRO) function has been proposed to contribute for detecting and correcting the mobility issues including too late HO, too early HO, and HO to the wrong cells. This function can be more effective in reducing these challenges related to mobility when proper optimization settings is performed for the handover control parameters (HCPs) (i.e., time-to-trigger (TTT) and handover margin (HOM)). In this paper, a trigger timer is proposed to reduce the unnecessary HOs. Meanwhile, this work proposes a weighted algorithm for optimizing the HCPs automatically based network experiences. The proposed algorithm rely on various factors for performing the optimization process. That includes, mobile movement speed, network traffic load, and the measurement report of the received signal reference power. Research work conducted by Matlab simulator that implement HetNets that consider Fifth Generation (5G) network and system settings based on 3GPP. Besides, 15 users were investigated using several mobile speed scenarios over Voronoi 5G network. The simulation results show that a significant achievement has been performed by the proposed algorithm as compared to the other algorithms investigated from the literature. The proposed algorithm has minimized the Radio Link Failure (RLF), Handover Ping-Pong (HOPP), Handover Probability (HOP), and handover interruption time by 8.8 %, 6.9 %, 6.7 %, and 344 %, respectively, lower than the other algorithms presented

Topical anesthesia in phacoemulsification

Purpose : To evaluate the efficacy of topical anesthesia; topical Benoxinate 0.4% (Oxybuprocaine) and Xylocaine (Lidocaine) gel, in selected cataract patients as an alternative to peribulbar or retrobulbar block anesthesia during cataract surgery. Materials and Methods : Prospective non-comparative evaluation of patients′ and surgeon′s satisfaction at the end of the procedure. Three hundred patients (300 eyes) were included in the study. The procedure was explained to patients with details regarding what will happen and what to expect during surgery. All patients received topical anesthesia with Benoxinate 0.4% eye drops and Xylocaine gel 2%. All surgeries were done by the same surgeon using the same machine (updated LEGACY phacoemulsifier, Alcon) and approach (clear corneal incision) and followed by a foldable intraocular lens (IOL) implantation. Results : None of the patients had severe pain during the procedure; only 2% (six of 300) required use of intravenous sedation (Propofol), both the surgeon′s and the patients′ satisfaction were high. Eye movements and blepharospasm were not significant problems, and no serious complications occurred. Rate of vitreous loss due to posterior capsule tear/rupture was within literature reported range and not different from our previous experience. Conclusion : Topical anesthesia is a satisfactory and safe alternative to retrobulbar and peribulbar anesthesia for clear corneal phacoemulsification and intraocular lens implantation in selected cataract patients in the hands of experienced cataract surgeon

Knowledge, attitude, and practice toward COVID-19 among Iraqi people: a web-based cross-sectional study

Background: Iraq was among the first countries invaded by the novel human coronavirus (SARS-COV-2) after China. This study aimed to assess the Iraqi people's knowledge, attitudes, and practices toward COVID-19 during the pandemic.  Methods: A cross-sectional study recruiting an online self-reported survey conducted from 17-31 July 2020. Data of 877 participants have undergone descriptive, univariate, and multivariable regression analyses, respectively, to assess the differences in mean scores and identify factors associated with knowledge, attitudes, and practices (KAP) toward COVID-19. Results: Most of the respondents (78.8%) from the urban region, highly educated (69.7%), aged less than 45 years (61.2%), females (58.3%), married (51.9%), and 74.0% self-ranked health as good. Less than half (45.4%) were employed; however, the average monthly income was USD 400 or more in about 66.8% of them. The mean knowledge, attitude and practice score was 15.57 ± 2.46 (range: 0-20), 38.88 (SD = 3.57, (range: 11-55), and 5.13 (SD = 1.14, range: 0–6), respectively. Findings of regression analysis showed that higher educated (p< 0.001), urban residents (P <0.001), employed (P =0.040), and having an income level of USD 400 or more (P <0.001) were significantly associated with upper knowledge score. Female gender and employed respondents are significantly associated with positive attitude scores, but inversely respondents with an income of USD 400 or more are significantly associated with a negative attitude. Regarding practice score, the female gender and those living in an urban region had better practice, but the young age group (0-44 years) was significantly associated with the weak practice. Conclusion: Although Iraq has adopted a preventive and precautionary plan to control the spread of coronavirus. However, the public's knowledge and attitude toward COVID-19, coupled with the unstable political and security situation, have greatly affected the commitment to preventive measures