Hard Exudate Extraction from Fundus Images using Watershed Transform

Diabetic Retinopathy is a medical condition which affects the eyes due to increased blood sugar levels. This is characterized by presence of exudates - deposits of lipids in the posterior pole of the retina. If this ailment is not treated in earlier stages these deposits can cause blurred vision or even permanent blindness. This paper concentrates on extraction of hard exudates and optic disc from the retinal images of eyes using Marker based Watershed approach, which uses the minima imposition method to create mask and marker. The varying contrast across all the images has been taken care by a non-linear equation. Once these bright objects have been extracted from fundus images, area estimation is performed to eliminate the optic disk, thus retaining only exudates. These images have been procured from publicly available databases. Though software systems are easy to install, they prove to be expensive in terms of time and cost; thus this method has also been implemented on FPGA for an on-chip solution. The precision and sensitivity for exudate extraction sans optic disk are found to be 92.4% and 83.78% respectively.  Though other techniques exist which provide better accuracy, the method described in this paper is found to be hardware friendly in comparison with other proven methods. Few steps of the algorithm developed are implemented on FPGA to provide an embedded system approach to this work, considering the advantages of a hardware-software combination

Impact of clinical pharmacist's educational intervention tools in enhancing public awareness and perception of antibiotic use: A randomized control trial

Introduction: In most developing countries, antimicrobial resistance is a public threat, and insufficient knowledge of antibiotics among the public adds to it. This study aimed to determine the efficacy of the clinical pharmacist's pamphlets and video-based educational tools to address the public's knowledge, attitude, and practice gaps on antibiotic use. Methods: This was a pre-and post-intervention cohort study of the adult population in South India who can read and understand Tamil or English. The study participants were designated into two groups-usual care group (pamphlet-based) and interventional group (video-based), with a pre-intervention assessment using a self-administered questionnaire, followed by an educational intervention by a clinical pharmacist, and finally, a post-intervention assessment after three months. Result: Of the162 respondents, the majority were female (58%), in the age group of 26–35 (30%), with intermediate education (43%) from a middle-income family. The mean score calculated for each domain among the two groups: knowledge score (Pamphlet based-Pre: 2.26 ± 1.13; post: 3.23 ± 1.02), (Video based-Pre: 2.22 ± 1.45; post: 3.95 ± 0.89), Attitude score (Pamphlet based-Pre: 2.53 ± 1.96; post: 3.23 ± 0.9), (Video based-Pre: 2.39 ± 1.81; post: 4.21 ± 1.35), Practice score (Pamphlet based-Pre: 2.19 ± 1.02; post: 4.46 ± 1.81). A significant improvement was observed in all domains of the video-based counselling group compared to the pamphlet-based (p < 0.001). Conclusion: Clinical pharmacists can effectively help in combating growing catastrophic AMR. Newer technologies need to be deployed in healthcare to educate the unreached. This study gives an insight into the technology-supported educational tool to provide awareness to the public effectively